How Do Prescription Drug Plans Work?
Here is important information you need to know about prescription drug plans:
Annual Deductible — Most plans have a deductible you must pay for a Part D plan. Your deductible may be different, or waived entirely, but the max amount you can be charged is $615 in 2026. You'll pay a discounted price for your medications until you have satisfied the deductible. After that, you begin initial coverage.
Initial Coverage — During initial coverage, you pay a copay or coinsurance for your medications based on your plan’s formulary. Each prescription drug plan separates its medications into tiers. Each tier has a copy amount for which you are responsible. It is typically separated by generic drugs, preferred name brands, even more specialized medications, and etc. In 2026, this phase continues until you reach the cap of $2,100.
Catestrophic phase - Once your out-of-pocket expenses or coered drugs reach the $2,100 limit, you enter this phase where you'll pay $0 for covered Part D drugs for the remainder of the year.
Prescription Payment Plan
In 2025, CMS released the Prescription Payment Plan (P3) to assist beneficiaries with paying for prescriptions that will cost in excess of the yearly cap. The cap for 2026 is $2,100. If your medications are expected to be that much or more; you can contact the third party company for your prescription plan and request to enroll in the plan. You can also disenroll at any time. They will divide the remainder of the maximum-out-of-pocket by the number of months left in the year and that will be your monthly payment for all medications. You will pay that company directly and won't pay anything when picking up scripts from the pharmacy. More information is on the Medicare.gov website.
How would I enroll?
Fill out the form and we will be in contact soon to talk.
See Which Plans Are In Your Area Today
By submitting your information, you acknowledge a licensed insurance agent may contact you by phone, email, or mail to discuss and quote Medicare Advantage Plans, Medicare Supplement Insurance, or Prescription Drug Plan
How Do Prescription Drug Plans Work?
Here is important information you need to know about owning a prescription drug plan:
Annual Deductible — Most plans have a deductible you must pay for a Part D plan. Your deductible may be different, or waived entirely, but the max amount you can be charged is $505 in 2023. You'll pay a discounted price for your medications until you have satisfied the deductible. After that, you begin initial coverage.
Initial Coverage — During initial coverage, you pay a copay for your medications based on your plan’s formulary. Each prescription drug plan separates its medications into tiers. Each tier has a copy amount for which you are responsible. It is typically separated by generic drugs, preferred name brands, even more specialized medications, and etc. In 2023, the initial coverage cap is $4,660. After you and the insurance company together have paid this amount, then you enter the coverage gap.
The Coverage Gap – During the coverage gap, you will still generally have significant discounts for generic medications. Typically, you will pay 25% for name brand medications and 37% for generics. Your gap spending will continue until you have paid $7,400 out of your own pocket in 2023.
Catastrophic Coverage – If you should spend past the coverage gap, your plan will begin to pay up to 95% of the costs of your formulary medications for the rest of the year.
How would I enroll?
Fill out the form and we will be in contact soon or press the "Click to Call" button above to call us today!
See Which Plans Are In
Your Area Today
By submitting your information, you acknowledge a licensed insurance agent may contact you by phone, email, or mail to discuss and quote Medicare Advantage Plans, Medicare Supplement Insurance, or Prescription Drug Plan
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