Prescription Drug Coverage · Side-by-Side
Plain English. Five calm steps. No pressure.
Two drug plans can look alike and cost you very different amounts. The plan with the lowest premium isn't always the cheapest for your medicines. Here's how to compare your options — and find your real yearly cost.
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Your Comparison Path
Read them in order, or jump straight to what you need.
Every way to get drug coverage with Medicare.
Drug lists, tiers, rules and pharmacies.
Line up 3 plans and see your real total.
Simple moves that can lower what you pay.
When you're ready, choose and enroll yourself.
Step 1 Your Options
More Than One Way to Get Covered
Most people get drug coverage one of two ways. But if you have other coverage, it may already count — so check before you buy anything new.
| Stand-alone drug plan (PDP) | Medicare Advantage with drugs (MA-PD) | |
|---|---|---|
| Works with | Original Medicare, often with Medigap | Built into your Medicare Advantage plan |
| Premium | Separate monthly premium | Included in the plan's premium (often $0) |
| Doctors | Any doctor who accepts Medicare | Usually the plan's network |
| Pharmacies | Plan's pharmacy network | Plan's pharmacy network |
| Drug cost cap | $2,400 in 2027 | $2,400 in 2027 |
| Learn more | Part D guide → | Medicare Advantage guide → |
Other coverage that may already count:
From your own or your spouse's current or former employer. Ask whether it's "creditable" — and how it works with Medicare before you drop it.
Usually creditable drug coverage. Many people keep it instead of — or alongside — Part D.
You'll get drug coverage through Medicare Part D, often at very low cost. See ways to save →
Careful with retiree coverage: joining a Part D plan can sometimes end your employer or union retiree health coverage — for you and your family. Always call your benefits office first.
Step 2 What Makes Plans Differ
Same Rules, Different Details
Every plan follows Medicare's rules, including the $2,400 cap. But within those rules, each plan makes its own choices — and those choices decide what you pay.
Called a formulary. If your drug isn't on it, you'd generally pay full price. This matters more than anything else.
The same drug can sit on a low tier in one plan and a high tier in another — with very different copays.
Prior authorization, quantity limits and step therapy can add steps before a drug is covered.
"Preferred" pharmacies and mail-order often cost less. A non-network pharmacy usually isn't covered.
The monthly premium plus the deductible (up to $700 in 2027) set your starting cost. A higher premium can still mean a lower total if your copays are lower.
How drug tiers usually work:
| Tier | Usually includes | Your cost |
|---|---|---|
| Tier 1 | Preferred generic drugs | Lowest |
| Tier 2 | Generic drugs | Low |
| Tier 3 | Preferred brand-name drugs | Moderate |
| Tier 4 | Non-preferred drugs | Higher |
| Tier 5 | Specialty drugs | Highest (often coinsurance) |
Step 3 Compare Yearly Cost
Your Real Number Is the Yearly Total
Enter up to three plans you're considering. Use the estimated yearly drug cost the Medicare Plan Finder shows after you enter your drugs — or add up your expected copays. We'll apply the $2,400 cap and show your total.
Enter a premium or drug cost to see your yearly totals.
Estimate only. The yearly drug cost you enter is capped at $2,400, the 2027 Part D out-of-pocket limit for covered drugs. Drugs your plan doesn't cover don't count toward the cap. With Medicare Advantage, enter the plan's premium (often $0) — your Part B premium is the same in every plan, so it's left out.
Where do I find the yearly drug cost? At Medicare.gov's Plan Finder, enter your drugs, doses and pharmacy. Each plan then shows an estimated yearly drug cost. Or try our practice tool first.
Step 4 Ways to Save
Small Changes, Real Savings
Ask your doctor or pharmacist whether a generic or lower-tier drug would work for you.
For drugs you take every day, a 90-day supply by mail or at a preferred pharmacy often costs less.
If your income and resources are limited, Extra Help can lower your premium, deductible and copays — and removes the late penalty. Apply through Social Security.
ssa.gov/extrahelpThe Medicare Prescription Payment Plan lets you pay your drug costs in monthly amounts instead of all at once. Ask your plan.
Free to useIf a drug you need isn't covered or has a restriction, your doctor can ask the plan for an exception.
Covered insulin is capped at $35 a month, and most recommended adult vaccines cost $0 under Part D.
Insulin ≤ $35/monthAbout drug coupons: manufacturer copay coupons generally can't be used with Part D. Discount cards may sometimes beat your plan's price — but what you pay that way usually doesn't count toward your $2,400 cap. Ask your pharmacist to check both prices.
Step 5 Compare & Enroll
When You're Ready — And Only Then
Before you choose, confirm:
Choose your state to compare the plans we offer and enroll yourself:
Want to see every drug plan in your area? Use the Medicare Plan Finder at Medicare.gov or call 1-800-MEDICARE (TTY 1-877-486-2048), 24 hours a day. Your State Health Insurance Assistance Program (SHIP) also offers free, unbiased help.
Costs, enrollment windows and the late penalty. Part D guide →
Your yearly chance to switch, Oct 15 – Dec 7. Open Enrollment guide →
Why you shouldn't go without drug coverage. Penalty guide →
No pressure · No sales calls · Your choice, your pace
Common Questions
Not always. Your total yearly cost includes the premium, the deductible and what you pay for each prescription. A plan with a higher premium can cost less overall if it covers your drugs on lower tiers.
Both follow the same Medicare rules, including the $2,400 yearly cap in 2027. The better choice depends on which plan covers your specific drugs at the lowest total cost — and on whether you prefer Original Medicare or Medicare Advantage for your medical care.
Your doctor can ask the plan for a coverage exception. You can also ask whether a similar covered drug would work for you.
Manufacturer copay coupons generally can't be used with Part D. Pharmacy discount cards may sometimes cost less, but what you pay with them usually doesn't count toward your yearly out-of-pocket cap.
Every year during Open Enrollment, October 15 – December 7. Plans change their drug lists, tiers, pharmacies and costs every January, and your medicines may change too.
Still have a question? Just ask.
Talk face-to-face with our Medicare AI Avatar, or type your question to our AI Assistant — free, any time, no sign-up and no sales pitch.
Education First. Enrollment Second.