- Your out-of-pocket costs for covered drugs are capped at $2,100 in 2026 and $2,400 in 2027.
- Covered insulin costs no more than $35 for a month's supply.
- If money is tight, Extra Help can lower your premiums and copays.
Two ways to get drug coverage
You can add a stand-alone Prescription Drug Plan to Original Medicare (with or without a Medigap policy), or choose a Medicare Advantage plan that includes drug coverage. Both are offered by private companies approved by Medicare.
Good news about costs
Once you reach the yearly cap, you won't pay anything more for covered Part D drugs for the rest of that calendar year.
Spread your costs month by month
The Medicare Prescription Payment Plan lets you pay your drug costs in monthly installments over the year, instead of all at once at the pharmacy counter. It's free to join through your drug plan. It can be especially helpful if you take expensive medicines early in the year.
Extra Help for limited incomes
Extra Help is a Medicare program that helps people with limited income and savings pay for Part D premiums, deductibles and copays. You automatically qualify if you have full Medicaid, get help from a Medicare Savings Program, or receive Supplemental Security Income (SSI). Others can apply through Social Security — online, by phone, or at a local office.
It's worth checking. Income and resource limits are higher than many people expect, and some things — like your home and car — don't count as resources.
Tips for saving on medicines
- Ask your doctor whether a generic or lower-tier drug would work for you.
- Use a "preferred" pharmacy in your plan's network.
- Consider 90-day supplies or mail order for medicines you take every day.
- Review your plan every fall — formularies and prices change each year.
Avoid a lifelong penalty
If you go 63 days or more in a row without Part D or other "creditable" drug coverage after you're first eligible, you may pay a late enrollment penalty for as long as you have Medicare drug coverage. Even if you take few medicines today, having coverage protects you.
