Medicare Part D Plans (Prescription Drug Coverage) — Licensed Advisor in NJ, NY, FL & More
Original Medicare doesn't cover most prescription drugs. A Medicare Part D plan fills that gap — but plans differ in which drugs they cover and what you'll pay. Here's how to choose, and how to avoid the late-enrollment penalty.
What Is Medicare Part D?
Medicare Part D is prescription drug coverage offered through private insurance companies approved by Medicare. It helps pay for the medications you take at home — the ones Original Medicare (Parts A and B) generally does not cover.
You can get Part D in one of two ways: as a standalone prescription drug plan that works alongside Original Medicare (and a Medigap policy, if you have one), or built into a Medicare Advantage plan that includes drug coverage (an MA-PD plan).
You cannot have a standalone Part D plan and a Medicare Advantage plan that includes drug coverage at the same time. Anil Khanchandani helps you confirm which path fits your situation before you enroll.
How Part D Plans Work — Formularies and Tiers
Every Part D plan has a formulary: the list of drugs it covers. Formularies are organized into tiers, and the tier your drug falls into determines your cost.
- Tier 1 — Preferred generics: lowest copay
- Tier 2 — Generics: low copay
- Tier 3 — Preferred brand-name drugs: moderate cost
- Tier 4 — Non-preferred drugs: higher cost
- Tier 5 — Specialty drugs: highest cost, often coinsurance rather than a flat copay
Two plans can have very different prices for the exact same medication, depending on how each one tiers that drug — and whether it's on the formulary at all. This is why matching the plan to your specific prescription list matters more than the headline premium.
The Part D Late-Enrollment Penalty — Why Timing Matters
If you go without creditable drug coverage for 63 or more days in a row after your Initial Enrollment Period, you may owe a late-enrollment penalty — and it's permanent. The penalty is added to your premium for as long as you have Part D.
The penalty is calculated based on how many full months you went without coverage, so even if you don't take many medications today, enrolling on time protects you from a lasting surcharge later. A licensed advisor can help you confirm whether your current coverage counts as creditable.
2026 Part D Costs and the Out-of-Pocket Cap
Part D costs include a monthly premium, an annual deductible (which varies by plan, up to a federal maximum), and your share of each prescription.
A major change in recent years: Part D now includes an annual out-of-pocket maximum on covered drugs. Once your out-of-pocket spending on covered prescriptions reaches the cap, you pay nothing more for covered drugs for the rest of the year. This replaced the old "donut hole" coverage gap and offers real protection for people with high drug costs.
Because exact figures and formularies change every year, reviewing your plan annually during the fall enrollment window is the best way to avoid overpaying.
How Part D Fits With Your Other Coverage
With a Medigap plan: Medigap does not include drug coverage, so you'd add a standalone Part D plan alongside it. This pairing gives you broad provider freedom plus drug coverage.
With Medicare Advantage: Most Medicare Advantage plans already include Part D (MA-PD). If yours does, you do not add a separate Part D plan.
Not sure which setup you have or need? That's exactly the kind of question Anil walks through with you — at no cost.
Get Personalized Part D Guidance
You deserve a plan matched to the medications you actually take — not a guess. Anil Khanchandani compares Part D plans available in your area against your specific prescription list, your pharmacy, and your budget, and explains the trade-offs in plain language. There's no cost and no obligation.
Anil is licensed in New Jersey, New York, Florida, California, Georgia, Maryland, Michigan, North Carolina, Ohio, Pennsylvania, South Carolina, Texas, and Virginia.
Frequently Asked Questions About Medicare Part D
IMPORTANT DISCLOSURE:
We do not offer every plan available in your area. Currently we represent 0-78 organizations which offer 0-2,613 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.
The exact carrier and plan counts are determined by your zip code and county.
This website is operated by US Life Solutions, a licensed insurance agency. We are not connected with or endorsed by the U.S. Government or the federal Medicare program.
Anil Khanchandani is licensed as an insurance agent in New Jersey, New York, Florida, California, Georgia, Maryland, Michigan, North Carolina, Ohio, Pennsylvania, South Carolina, Texas, and Virginia, and may only discuss Medicare Part D plans in states where he holds an active license.
UnitedHealthcare® is a registered trademark of UnitedHealth Group Incorporated. Anil Khanchandani is a contracted agent representing UnitedHealthcare® and is not an employee of UnitedHealthcare. Humana and Aetna are registered trademarks of their respective companies. US Life Solutions is an independent agency and is not affiliated with, endorsed by, or acting on behalf of UnitedHealthcare®, Humana, or Aetna.
This is a solicitation for insurance.
Medicare has neither reviewed nor endorsed this information.