Medicare Part D Prescription Drug insurance is optional coverage. To enroll, you must have Medicare Part A and/or Part B. There are several factors you should consider when getting a Part D plan.
On this page you will find:
Other useful links:
Why should I get a Part D Prescription Drug Plan?
- You use prescription drugs on a regular basis
- You think you may need prescription drugs in the future
- You do not have creditable prescription drug coverage (as good as Medicare’s)
- You are worried about increasing prescription drug costs
- You are having trouble paying for your prescription drugs
Not enrolling in a Medicare Part D plan when you are first eligible may result in a lifetime late enrollment penalty. However, you will not incur a penalty as long as you have had “creditable” drug coverage through an employer policy, VA Benefits, or TriCare for Life.
How do I choose a Part D Prescription Drug Plan?
You will want to choose a plan offered by Medicare-approved insurance companies. Find Medicare-approved plans in:
- Your Medicare & You booklet
- The Medicare Plan Finder tool
- Or contact us for assistance
PART D Costs
Your cost for a Part D Plan is going to be different based on the following:
- The drugs you use
- The plan you choose (cost of premium, copayments, deductible)
- Costs of your drugs in the coverage gap (aka “donut hole”)
- Whether you go to a pharmacy in your plan’s network
- Whether the drugs you use are on your plan’s formulary (or list of covered drugs)
In addition to your Part D plan premiums, there is a Part D Income Related Monthly Adjustment Amount (IRMAA) that is paid directly to Medicare.
| Part D Income Related Monthly Adjustment Amount (IRMAA) | ||
|---|---|---|
| 2024 income tax filed in 2025 | 2026 Part D Plan Premium + IRMAA | |
| Individual Tax | Joint Tax | |
| $109,000 or less | $218,000 or less | Premium only |
| $109,001–$137,000 | $218,001–$274,000 | Premium + $14.50 |
| $137,001–$171,000 | $274,001–$342,000 | Premium + 37.50 |
| $171,001– $205,000 | $342,001–$410,000 | Premium + $60.40 |
| $205,001–$499,999 | $410,001–$749,999 | Premium + $83.30 |
| 500,000 or more | $750,000 or more | Premium + $91 |
Review Your Part D Plan Every Year
Plans may change annually! Plans may change their formularies, and network pharmacies every year and sometimes during the year.
You can change your Part D plan every year during Open Enrollment between October 15 and December 7 to start new coverage beginning January 1.
Evaluate your Part D costs:
- The Medicare Plan Finder on www.medicare.gov
- Free Part D Drug plan comparison through Montgomery County SHIP.