Are all Medicare Plan D the same?

No, Medicare Part D plans are not all the same; while they must meet federal standards for coverage, they differ significantly in costs (premiums, deductibles, copays), covered drug lists (formularies), pharmacy networks, and specific benefits, requiring comparison to find the best fit for your prescriptions and budget.


Are all Part D Medicare plans the same?

No, Medicare Part D plans are not all the same; they differ significantly in monthly premiums, deductibles, covered drugs (formularies), drug tiers, copays, and pharmacy networks, all offered by private insurers under Medicare guidelines, requiring comparison to find the best fit for your medications.
 

Can I change my Medicare Part D plan every year?

Yes, you can change your Medicare Part D plan every year during the Annual Enrollment Period (AEP) from October 15 to December 7, and it's often recommended to compare plans annually as benefits, costs, and drug formularies change. Changes made during AEP take effect on January 1 of the next year, but you can also switch during specific Special Enrollment Periods (SEPs) if you have a qualifying event, like moving or losing other coverage. 


Does Medicare Part D have a separate premium?

Each Part D plan has a different monthly premium. Some people do not have to pay a premium. For example: If you are on Medicaid or a Medicare Savings Program, you can choose a plan that does not have a premium.

Is Medicare Part D worth it for seniors?

While the lower-tier drugs may be manageable to pay for without Part D coverage, the higher tiers may give you sticker shock. So, while you may have to pay a premium, deductible, copay or coinsurance, your overall Medicare Part D costs will likely be significantly less than if you don't have coverage.


The Collapse of Medicare Part D – What’s Going On With Drug Coverage in 2026



What is the most popular Medicare Part D plan for seniors?

Best Medicare Part D Prescription Drug Plans for 2026
  • Best Overall: UnitedHealthcare.
  • Best for Plan Costs: Humana.
  • Best for Overall Quality: Aetna.
  • Best for Customer Satisfaction: HealthSpring (formerly Cigna)


What are the disadvantages of Medicare Part D?

Disadvantages of Medicare Part D Prescription Drug plans include: Need to anticipate your prescription drug needs for the year: Part D plans differ in the types of drugs they cover. Knowing your medical situation can help you select a plan that is right for you and covers the prescription drugs you expect to need.

Why is my Part D premium so high?

Your Medicare Part D premium might be high due to increased drug costs, changes from the Inflation Reduction Act (IRA) shifting costs, your higher income (IRMAA), a late enrollment penalty, or the specific plan you chose, as insurers adjust premiums based on spending and new federal rules, even with efforts to stabilize costs. 


Are Part D premiums deducted from social security?

Yes, Medicare Part D premiums can be deducted from your Social Security check, and it's a common way to pay, but you must arrange it with your plan provider (or it happens automatically for the income-related surcharge). While your Part B premium usually comes out automatically, for Part D, you typically choose to have your base premium deducted when enrolling, or you'll receive a bill directly from the plan. Higher-income earners also pay an Income-Related Monthly Premium Surcharge (IRMAA), which is automatically deducted from Social Security regardless of how you pay your plan premium. 

What are the biggest mistakes people make with Medicare?

The biggest Medicare mistakes involve missing enrollment deadlines, failing to review plans annually, underestimating total costs (premiums, deductibles, copays), not enrolling in a Part D drug plan with Original Medicare, and assuming one-size-fits-all coverage or that Medicare covers everything like long-term care. People often delay enrollment, get locked into old plans without checking for better options, or overlook financial assistance programs, leading to higher out-of-pocket expenses and penalties. 

How will Medicare Part D change in 2025?

Medicare Part D changes for 2025, driven by the Inflation Reduction Act (IRA), significantly lower out-of-pocket drug costs by introducing a $2,000 annual cap on spending, eliminating the coverage gap (donut hole), and adding a voluntary Medicare Prescription Payment Plan for monthly payments, simplifying the benefit into deductible, initial, and catastrophic phases with lower costs overall for beneficiaries.
 


What drugs are not covered by Part D?

Medicare Part D generally excludes drugs for weight loss/gain, fertility, hair growth, and sexual dysfunction (unless for other conditions), plus over-the-counter (OTC) meds, cough/cold relief, most vitamins, and those covered by Part A/B (like hospital drugs). While plans must cover certain classes (like antidepressants, cancer meds), specifics vary by plan's "formulary," and exceptions can sometimes be requested. 

How do I choose a Medicare Part D plan?

To choose a Medicare Part D plan, use the official Medicare Plan Finder on Medicare.gov (entering your zip code) to compare costs based on your specific prescriptions, dosages, and preferred pharmacies, focusing on the lowest total cost (premiums + drug costs). Key steps include logging in with your Medicare ID for a personalized view, adding all your drugs (brand/generic), selecting pharmacies (preferred ones often have lower costs), and reviewing plan details like deductibles and tier structures to find the best overall fit for your health and budget. 

What is the maximum out-of-pocket for Medicare Part D?

For Medicare Part D, the maximum out-of-pocket (MOOP) limit for covered prescription drugs is $2,100 in 2026, a new cap established by recent legislation that significantly reduces costs for beneficiaries after they reach this threshold, paying $0 for covered drugs for the rest of the year. This cap includes deductibles, copays, and coinsurance for covered drugs but excludes monthly plan premiums, and it applies to all Part D enrollees, with lower-income individuals qualifying for "Extra Help". 


Which two Medicare plans cannot be enrolled together?

A person cannot use Medicare Advantage (Part C) and Medigap at the same time. If a person already has Medicare Advantage, they cannot enroll in Medigap. Those looking to take out a Medicare Advantage plan may need to leave their Medigap policy, as they will no longer be able to use their Medigap insurance.

What is the best insurance to go with Medicare?

There's no single "best" Medicare plan, as it depends on your needs, but top-rated providers for Medicare Advantage (Part C) often include Aetna, UnitedHealthcare (AARP), Humana, and Kaiser Permanente, praised for wide networks, low costs, or extra benefits like dental/vision; for Medicare Supplement (Medigap), UnitedHealthcare/AARP and Humana frequently lead in perks and overall value. Always compare plans on Medicare.gov for your specific location and prescriptions, considering costs, doctor networks, and extra benefits like vision, dental, or fitness programs. 

Can I deduct Medicare Part D premiums on my taxes?

Medicare B — This is supplemental insurance, and you can include it. Medicare Part D — This is voluntary insurance and it's always includable.


At what age do you stop paying Medicare premiums?

Your CalPERS health coverage will automatically be canceled the first day of the month after you turn 65. See Cancellation of CalPERS Health Coverage for information on reinstating your health coverage.

Are Plan D premiums based on income?

With Part D, the extra amount you pay is determined by Medicare based on your tax-reported income, but your total costs will depend on the Part D plan you have. Part D plans are only provided by private insurance companies, so premium amounts will vary.

Who has the best Medicare Part D?

There's no single "best" Medicare Part D plan; it depends on your drugs and needs, but UnitedHealthcare (UHC), Humana, Wellcare, and Cigna are consistently top-rated for overall coverage, low costs, or specific perks like $0 deductibles or preferred pharmacies, with UHC often cited as best overall for national coverage and Humana for value/diabetes care. Use the official Medicare Plan Finder to compare plans in your ZIP code for accurate pricing and drug coverage. 


What do most people pay for Medicare Part D?

The average cost for a standalone Medicare Part D plan is around $34.50 per month for 2026, but costs vary widely by plan, location, and income, with deductibles up to $615 and copays/coinsurance for drugs. For Medicare Advantage (Part C) plans with drug coverage (MAPD), the average premium is lower, projected to be about $11.50 monthly in 2026, plus your Part B premium. Key costs include premiums, deductibles (max $615 in 2026), copays/coinsurance, and potential Income-Related Monthly Adjustment Amounts (IRMAA) for higher earners. 

How can I lower my Medicare Part D prescription costs?

Other ways to lower your prescription drug costs:
  • Join Medicare drug coverage (Part D): ...
  • Ask your doctor if you can take a generic drug, or a cheaper brand-name drug (if one's available).
  • Check costs for mail-order pharmacies. ...
  • Learn if the Medicare Prescription Payment Plan might be able to help you manage your costs.


What is the best prescription drug plan for seniors on Medicare?

There's no single "best" Medicare Part D plan; it depends on your medications and budget, but top-rated providers for low costs/premiums often include Humana, Wellcare, UnitedHealthcare (AARP), and Cigna, with Humana Value Rx and UHC's AARP plans frequently highlighted for low deductibles or $0 options for generics, while the official Medicare Plan Finder (Medicare.gov) is the essential tool for comparing plans in your specific area. Always check the plan's formulary (drug list) and pharmacy network against your needs. 


What does Dave Ramsey say about Medicare?

Dave Ramsey's Medicare advice centers on planning ahead, understanding enrollment periods to avoid penalties, using Health Savings Accounts (HSAs) if possible, and supplementing Original Medicare with Medigap or Medicare Advantage (Part C) to cover gaps like dental, vision, and long-term care, stressing that mistakes can be costly and recommending expert advice for personalized choices. 

Which medicare advantage plan denies the most claims?

Centene (Wellcare) and CVS Health (Aetna) have faced scrutiny for high prior authorization denial rates in Medicare Advantage (MA) plans, with reports showing they had the most denied requests in 2023, though many denials were overturned on appeal, indicating issues with their strict criteria, while UnitedHealthcare also faces lawsuits and uses technology that has led to increased denials, especially for post-acute care, highlighting systemic challenges with MA plan claim approvals.