Affordable coverage for your medications - updated for 2026.
Are you concerned about prescription drug costs? A Medicare Prescription Drug Plan (Part D) can give you peace of mind at an affordable price. Medicare prescription drug plans are made to supplement Original Medicare Plans A & B.
Typically, a prescription drug plan will provide four tiers of benefits - the higher the tier, the more expensive the copayments:
Drug costs under most Medicare Part D plans are low, but the amount you pay will vary by plan.
All Medicare Part D plans now have a maximum out-of-pocket limit of $2,100 for covered prescription drugs. Once you reach this limit, you pay nothing for covered medications for the rest of the calendar year. This is significantly lower than the 2024 limit of $8,000.
Here are the common terms that explain what you will pay for a Prescription Drug Plan.
The amount paid each month to keep your plan active.
Begins with your first prescription of the plan year. You pay the full cost of your prescriptions until your spending reaches the deductible amount. No plan's deductible can exceed $615 in 2026, and some plans have a $0 deductible.
If your plan has a $0 deductible, you skip straight to the Initial Coverage phase. Keep in mind that some deductibles may only apply to drugs on specific tiers. Monthly premium payments do not count toward your deductible. Note: covered insulins and vaccines are exempt from the deductible.
Begins immediately if your plan has no deductible, or once your prescription payments have met your plan's deductible.
During this phase, costs are shared across three parties:
Your share is paid as either a copayment (a set dollar amount) or coinsurance (a percentage of the drug's cost), depending on the tier level assigned to your drug.
This phase ends when your total out-of-pocket costs on covered drugs reach $2,100 for the year, at which point you enter Catastrophic Coverage. Monthly premium payments do not count toward this limit.
Begins when your out-of-pocket costs reach $2,100 on covered drugs. Once you hit this limit, you pay nothing for covered Part D drugs for the remainder of the plan year.
You will remain in this phase until December 31 of the plan year.
An option available in 2026 allows you to spread your prescription drug costs evenly across the calendar year rather than paying large amounts all at once. For example, if you hit your $2,100 out-of-pocket cap early in the year, you could opt to pay in even monthly installments instead of one lump sum.
This option does not lower your total drug costs - it simply makes budgeting easier for those on a fixed income.
The Coverage Gap ("donut hole") has been permanently eliminated. Starting back in 2025, there are only three phases.
You pay 100% of drug costs until you meet your deductible (up to $615). Some plans skip this phase entirely with a $0 deductible.
You pay 25% of covered drug costs. Your plan pays 65%, and the drug manufacturer covers 10%. This continues until you've spent $2,100 out-of-pocket.
After $2,100 out-of-pocket, you pay $0 for covered medications through December 31.
Our licensed agents are ready to find the best coverage for your needs at no cost to you.
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