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Compare Medicare Part D Plans

Medicare Part D is private-carrier prescription drug coverage for those enrolled in Original Medicare or Medicare Advantage (Part C). Read on to learn more about Part D prescription drug plans (PDPs) and compare plans to find the right fit for you.

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Compare the basics of Medicare Part D plans

Before deciding on a Medicare prescription drug plan, it’s important to understand the ins and outs of Medicare medication coverage. Depending on carrier, location, and personal needs, prescription drug plans differ greatly in cost, coverage, and tier.

Different types of Medicare prescription drug coverage

There are two main types of Medicare prescription drug coverage:

Medicare Part D prescription drug plans (PDPs), which work alongside Original Medicare or a Medicare Advantage (Part C) plan that does not include prescription drug coverage
Medicare Advantage Prescription Drug plans (MA-PDs) which offer prescription drug coverage as part of a larger Medicare Advantage plan

Many Special Needs Plans and the occasional Medigap plan also offer prescription drug coverage—if you enroll in one of these plans, you may not need separate prescription coverage.

Costs and coverage levels

Consider the different payment and coverage structures when comparing plans. You’ll want to make sure all your necessary prescriptions are covered. If you pay a higher monthly premium, you’ll generally pay less at the pharmacy in copayments or coinsurance. Some plans will only cover part of the cost for specific medications, leading to greater out-of-pocket costs.

Pharmacy networks and formularies

Most Part D plans specify networks of pharmacies where beneficiaries can fill their prescriptions. When comparing plans, make sure your preferred pharmacy is within that network. You’ll also want to check the plan’s formulary, or list of covered drugs, to ensure your medications are included and are aware of any restrictions or limitations presented.

Compare Medicare Part D tiers

Most Medicare Part D prescription drug plan formularies list their approved drugs in tiers, with drugs in a lower tier costing less out-of-pocket for beneficiaries, the cost going up the higher the tier (except Tier 6, as noted below). Not all plan formularies follow this exact structure, but the following approximates what you’ll see when you compare plans.

Tier 1

Preferred Generic:

Commonly available medications produced by multiple manufacturers

Tier 2

Generic:

Similar to those in Tier 1, with fewer options available and slightly higher copayments

Tier 3

Preferred Brand:

Brand-name drugs not available in generic form but cost-effective compared to other alternatives

Tier 4

Non-Preferred Drug:

Higher-cost brand name or generic drugs

Tier 5

Specialty Tier:

Drugs used to treat ongoing health conditions ordered through a specialty pharmacy with very high copayments

Tier 6

Select Care Drugs:

Very low copayment drugs used to treat common conditions such as diabetes, hypertension, and osteoporosis

How to compare Medicare Part D plans

The first step in comparing Medicare Part D plans to find the right fit for you is to gather all the information you need to make an informed decision. Before searching and comparing plans, have the following information ready:

ZIP code. Your location will determine which plans are available to you.
Current prescriptions. List all your medications, including drug names, dosages, and quantities.
Preferred pharmacies. Collect the names and addresses of pharmacies you use regularly to check if they are in the network of the plans you compare.
Your monthly budget. Calculate how much you can afford for monthly premiums, copayments, and coinsurance.

Enter the information you’ve gathered into our comparison tool. Once you’ve provided your information, you’ll see a list of Part D plans that meet your criteria. From there, you can compare based on the above factors and extra benefits such as mail-order service that some plans offer. Once you’ve found a fit, you can enroll online or by phone.

Medicare Part D frequently asked questions

How do I enroll in Medicare Part D?

To enroll in Medicare Part D, you must have Medicare Part A and/or Part B. If eligible, you can use our online comparison tool to search plans and enroll during one of the specified enrollment periods listed in the question below.

You are eligible for Medicare if:

you are a U.S. citizen who has lived in the U.S. for the past five years and 65 years of age, or
you have one of the conditions qualifying you for earlier coverage, such as end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS).

When do I enroll in Medicare Part D?

Medicare Part D enrollment is limited to specific enrollment periods throughout the year. These are the most common times to enroll in or change a Medicare Part D prescription drug plan:

Your Initial Enrollment Period begins three months before your 65th birthday month, and includes your birthday month and the three months following; after enrolling for Original Medicare, you can enroll in a PDP during this period.
The Medicare Annual Enrollment Period runs from October 15 through December 7 each year; you can enroll in a PDP for the first time or change your plan during this period.
The Medicare Advantage Annual Enrollment Period runs from January 1 through March 1 each year; during this period, if you are already enrolled in a Medicare Advantage Plan (with or without drug coverage), you can switch to another Medicare Advantage Plan (with or without drug coverage) or drop your Medicare Advantage Plan and return to Original Medicare. You’ll also be able to join a separate Medicare drug plan. You can only make one change during this period, and any changes you make will be effective the first of the month after the plan gets your request.

In addition, a qualifying event may trigger a Special Enrollment Period at another time. If you move to a new state or lose coverage for another reason, you may be able to add, drop, or change your prescription drug coverage during this time.

Who is eligible for Medicare Part D?

To enroll in a prescription drug plan, you must have Medicare Part A and/or Part B, which you can qualify for by age or certain special circumstances. To qualify by age, you must be a U.S. citizen who has lived in the U.S. for the past five years, and be 65 or approaching your 65th birthday. The following conditions may qualify you for Medicare coverage before age 65:

24 consecutive months receiving Social Security disability benefits
Kidney failure, also known as end-stage renal disease (ESRD), resulting in a kidney transplant or more than three months of dialysis treatment
Amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease)

How much does Medicare Part D cost?

There is no set cost for a Medicare Part D prescription drug plan. Some plans have higher premiums and lower copayments, while others have low premiums and greater out-of-pocket costs at the pharmacy. Compare plans from national and regional providers using our online tool to find a plan that fits your budget.

Clearlink Insurance represents Medicare Advantage HMO, PPO, PFFS, and PDP organizations that have a Medicare contract. Enrollment depends on the plan's contract renewal.

We do not offer every plan available in your area. Currently we represent 7 organizations which offer 275 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

Enrollment in a plan may be limited to certain times of the year unless you qualify for a Special Enrollment Period or you are in your Medicare Initial Enrollment Period.

Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.

For accommodations of persons with special needs at meetings call TTY 711.

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