Are Medicare Part D plans all the same?

No, Medicare Part D plans are not all the same; they differ significantly in costs (premiums, deductibles, copays), covered drugs (formularies), pharmacy networks, and extra benefits, even though all must meet federal standards for basic coverage. Because private companies offer these plans, you must compare them carefully to find one that covers your specific medications affordably, as being in the wrong plan can cost you significantly more.

Are all Medicare Part D 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.
 

What are the disadvantages of Medicare Part D?

One of the chief complaints about the program is the overwhelming complexity involved with choosing a prescription drug plan. Nearly 1,900 prescription drug plans exist overall, and depending on an enrollee's geographic region, beneficiaries must evaluate 45 to 66 plans.

Does everyone pay the same for Medicare Part D?

Note: Some people with higher incomes will pay more for their Part D premiums. This is called IRMAA, or income-related monthly adjustment amount. Learn more about IRMAA. The Medicare Part D Low-Income Subsidy (LIS, or "Extra Help") is open to beneficiaries with incomes up to 150% of the federal poverty level (FPL).

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. 

How Medicare Part D Works (2025)

What is the most popular Medicare Part D plan?

There isn't one single "most popular" plan, but UnitedHealthcare (AARP) and Wellcare are frequently cited as top choices for Part D, with UHC often praised for overall quality, network, and low deductibles, while Wellcare leads in affordability and $0 premium options in some areas. Other strong contenders include Cigna, Humana, and Aetna, known for different strengths like perks, $0 plans, or low-cost tiers, but the best plan depends on your specific drugs and location. 

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. 

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. 

Is Medicare Part D deducted from my social security check?

Yes, you can have your Medicare Part D (prescription drug coverage) premium deducted from your Social Security check, just like Part B, but you usually need to arrange it with your specific drug plan provider, though it often starts automatically if you have Part B premiums deducted. If your income is higher, an extra amount (IRMAA) will be deducted automatically, but for your base premium, you contact your insurer to set up direct withdrawal from your benefits. 

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 average Medicare Part D premium?

The average Medicare Part D premium varies slightly by source and year, but for 2026, estimates hover around $34.50 to $39 for stand-alone plans, with integrated MA-PDs often lower; however, premiums range widely from $0 to much higher, depending on the plan, location, and high-income surcharges (IRMAA). For 2025, the average was closer to $36-$46, while 2024 saw averages around $34.70 to $55.50 for stand-alone plans, with MA-PDs averaging around $12-$18 plus Part B. 

What are the four things Medicare doesn't cover?

Some of the items and services Medicare doesn't cover include:

• A heart valve repair or replacement.
• An organ transplant.
• Cancer-related treatments.
• Dialysis services for the treatment of End-Stage Renal Disease (ESRD)

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 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. 

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.

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.

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.

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 much will Medicare Part D cost in 2026?

The Part D deductible can be no more than $615 per year. In 2026, annual out-of-pocket Part D costs will increase from $2,000 to $2,100. If you take high-cost medications covered by Part D, you could see major savings. After meeting the out-of-pocket limit, you pay $0 for covered drugs for the rest of the year.

What is the best Medicare Part D plan?

The "best" Medicare Part D plan isn't one-size-fits-all; it depends on your specific prescription drugs, preferred pharmacies, and budget, but top-rated providers for 2026 often include UnitedHealthcare (UHC) for overall value/deductibles, Humana for low premiums/costs, and Aetna for quality/generics, with providers like Cigna (HealthSpring) also scoring high on satisfaction, requiring you to use the official Medicare Plan Finder to input your drugs for personalized results. 

Is it better to have a $500 deductible or $1 000 health insurance?

Doubling your deductible to $1,000 could save you up to 40 percent. For example, on average, a $500 deductible costs $125/month, or $1,500/year, in premiums. The average for a $1,000 deductible is about $110/month, or $1,337/year.

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". 

What are the three words to remember for a Medicare wellness exam?

For a Medicare Wellness Exam's cognitive test, the three common words to remember are often "banana," "sunrise," and "chair," used in the Mini-Cog screening to check your memory and thinking skills; you say them immediately and then recall them after a few minutes. 

Is it better to go on Medicare or stay on private insurance?

Neither Medicare nor private insurance is universally "better"; the best choice depends on individual needs, but Medicare often offers lower overall costs and simplicity for seniors, while private insurance excels in covering dependents and potentially offering more choice with networks/out-of-pocket caps, though at higher premiums. Medicare boasts lower admin costs and standardized coverage, but Original Medicare lacks an out-of-pocket maximum, a feature typically found in private plans and Medicare Advantage (Part C). 

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.