How to Evaluate and Choose Part D Prescription Drug Coverage
Insurance carriers no longer allow agents to enroll Medicare beneficiaries in standalone Medicare Part D prescription drug plans. As a result, RoseHealth is no longer able to provide client-specific advice or assistance for this important part of Medicare coverage.
This page provides resources to help you evaluate your Medicare Part D prescription drug plan options and make an informed decision about your coverage.
Because Part D premiums, formularies, pharmacy networks, deductibles, and prescription costs can change each year, we encourage you to review your coverage annually, even if you are satisfied with your current plan.
Steps to Review Your Part D Plan Options
Six steps, all on Medicare.gov.
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Go to Medicare Plan Finder
Open Medicare Plan FinderSelect Find Health & Drug Plans. You may sign in to your Medicare account or enter your ZIP code and continue as a guest.
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Answer a Few Coverage Questions
Medicare.gov will ask whether you receive assistance with prescription drug costs, such as:
- Medicaid or Medi-Cal
- Extra Help
- Other assistance with Medicare prescription drug costs
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Enter Your Prescriptions
Enter each prescription medication you currently take, including:
- Medication name
- Dosage
- Quantity
- How often you refill the prescription
Entering accurate information is important because your medications can significantly affect which plan has the lowest estimated annual cost.
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Select Your Preferred Pharmacies
Choose the pharmacies you prefer to use.
Part D plans may have different negotiated prices and preferred pharmacy networks, so the same prescription can cost significantly more or less depending on the pharmacy you select.
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Compare Your Plan Options
Medicare Plan Finder can estimate your monthly and annual prescription drug costs based on the medications and pharmacies you entered. Note: Medicare.gov will default to sorting plans by the lowest estimated annual total cost, which includes plan premiums, deductibles, and estimated prescription drug costs.
When reviewing plans, consider more than just the monthly premium. Compare:
- Estimated annual drug and premium costs
- Monthly premium
- Annual deductible
- Prescription copays or coinsurance
- Whether all of your medications are covered
- Drug restrictions, such as prior authorization, step therapy, or quantity limits
- Preferred pharmacy availability
A plan with the lowest premium is not necessarily the plan with the lowest overall cost.
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Click “Enroll”
Click “Enroll” next to the plan you choose and complete the application through Medicare.gov. After submitting, you should receive a confirmation that your enrollment request was submitted.
The plan will typically send additional enrollment information after processing your application, followed by your welcome materials and member ID card by mail.
Quick Reference Tools
CMS Plan FinderMedicare Plan Finder
Compare Medicare Part D and Medicare Advantage plans available in your area:
medicare.gov/plan-compare
Medicare.gov
medicare.gov
1-800-MEDICARE
1-800-633-4227
TTY: 1-877-486-2048
Important Medicare Dates
- October 1stMedicare typically makes plan information for the upcoming year available so you can begin reviewing your options.
- October 15th – December 7thMedicare's Annual Open Enrollment Period. During this time, you can join, switch, or drop a Medicare prescription drug plan.
- January 1stCoverage begins for plan changes made during the Annual Enrollment Period.
FAQs
Do I need to review my Part D plan every year?
Yes, we recommend it. Prescription drug plans can change their premiums, deductibles, formularies, pharmacy networks, and prescription costs from year to year.
Your prescriptions may also change, so the plan that worked well for you this year may not necessarily be the best value next year.
What happens if one of my prescriptions is no longer covered?
First, check whether another Part D plan covers the medication.
You may also want to speak with your doctor about covered alternatives. Depending on the circumstances, you may be able to request a formulary exception directly from the plan.
Can I change my Part D plan outside of Annual Enrollment?
Usually, you must wait for an applicable Medicare enrollment period.
However, certain circumstances may qualify you for a Special Enrollment Period, such as moving outside your plan's service area, losing certain coverage, or qualifying for programs such as Extra Help or Medicaid. Medicare determines eligibility based on your specific situation.
How do I know whether a plan covers my medications?
Each Part D plan has a formulary, which is its list of covered prescription drugs.
The easiest way to compare coverage is to enter your medications into Medicare Plan Finder. You can also review the plan's formulary directly through the insurance company.
If I want to stay with my current Part D plan, do I need to do anything?
Generally, no.
If you have reviewed your plan's changes for 2027 and are comfortable continuing your coverage, you usually do not need to re-enroll. Your existing plan will generally continue automatically into the new year as long as the plan remains available to you.
Be sure to review the Annual Notice of Change your plan sends you so you understand any changes to your premium, deductible, prescription costs, formulary, or pharmacy network for 2027.
Is the new Medicare GLP-1 program part of my Part D prescription drug coverage?
No. The Medicare GLP-1 Bridge is a separate Medicare program and is not part of your regular Part D drug plan benefits.
If you qualify, certain GLP-1 medications may be available through the program for a $50 monthly copay. You do not enroll in the GLP-1 Bridge through Medicare Plan Finder or by changing your Part D plan.
If you think you may qualify, visit Medicare.gov for current eligibility information and speak with your doctor or prescribing provider about next steps.
A Note from RoseHealth
RoseHealth remains available to assist you with your Medicare Supplement (Medigap) coverage, Medicare Advantage coverage, and other insurance needs.
For standalone Medicare Part D prescription drug plans, Medicare.gov provides a comprehensive tool that allows you to compare available plans based specifically on your prescriptions and preferred pharmacies.
There is never a cost to use Medicare.gov or Medicare Plan Finder.