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Medicare Part D: Prescription Drug Plans

Last reviewed: June 2026 · Reviewed by Galit Sacajiu MD, MPH

Medicare Part D is optional prescription drug coverage added to Original Medicare through private insurance companies approved by Medicare. As of 2026, the out-of-pocket cap for covered drugs is $2,000 per year — a major improvement from prior years.

How Part D Works

1
Deductible phase
You pay 100% of drug costs until you meet your deductible (up to $590 in 2026 for standard plans).
2
Initial coverage phase
You pay your plan's copays or coinsurance for covered drugs. The plan pays the rest.
3
Out-of-pocket cap
Once you've spent $2,000 out-of-pocket on covered drugs in 2026, Medicare catastrophic coverage kicks in and you pay $0 for the rest of the year.

✅ 2026 Big Change: $2,000 Out-of-Pocket Cap

Starting in 2025, the Inflation Reduction Act capped Medicare Part D out-of-pocket drug costs at $2,000 per year. Before this, there was no true cap. This is especially important for people on expensive specialty medications.

What Is a Formulary?

Each Part D plan has a formulary — a list of covered prescription drugs organized into tiers. Lower tiers have lower copays; higher tiers cost more. Plans can change their formularies each year.

Tier 1
Generic drugs
Lowest copay (~$0–$10)
Tier 2
Preferred brand
Low copay (~$10–$45)
Tier 3
Non-preferred brand
Medium copay (~$45–$100)
Tier 4
Specialty drugs
25–33% coinsurance

Late Enrollment Penalty

If you don't sign up for Part D when first eligible and go 63+ days without creditable drug coverage, you'll pay a permanent late enrollment penalty: 1% of the national base beneficiary premium for each month you went without coverage.

Part D vs. Medicare Advantage Drug Coverage

Most Medicare Advantage plans include prescription drug coverage (MAPD plans), so you don't need a separate Part D plan. If you have Original Medicare, you need a standalone Part D Prescription Drug Plan (PDP).

Standalone Part D (PDP)

Works alongside Original Medicare (Parts A + B) or Medigap. You choose your plan based on your specific medications.

Compare Part D plans →

Medicare Advantage + Drug (MAPD)

Replaces Original Medicare and includes drug coverage in one plan. Usually the most convenient option.

Compare Advantage plans →