Costs for Medicare drug coverage

You'll make these payments throughout the year in a Medicare drug plan:

Your actual drug coverage costs will vary depending on:

  • Your prescriptions and whether they’re on your plan’s list of covered drugs ( formulary ).
  • What “tier” the drug is in.
  • Which drug benefit phase you’re in (like whether you’ve met your deductible, or if you’re in the catastrophic coverage phase).
  • Which pharmacy you use (whether it offers preferred or standard cost sharing, is out of  network , or is mail order). Your out-of-pocket drug costs may be less at a preferred pharmacy because it has agreed with your plan to charge less.  
  • Whether you get Extra Help paying your Medicare drug coverage costs.

Look for specific Medicare drug plan costs, and then call the plans you're interested in to get more details.

NEW INSULIN BENEFIT! The cost of a one-month supply of each Part D-covered insulin is capped at $35, and you don't have to pay a deductible. If you get a 60- or 90-day supply of insulin, your costs can’t be more than $35 for each month’s supply of each covered insulin.

Note

If your drug costs are higher than what you paid last year, talk to your doctor. There may be lower cost drugs you can use instead. This could save you in out-of-pocket costs throughout the year. If you want more information on drug prices, you can look at dashboards that highlight which manufacturers have been increasing their prices and also show other year-to-year drug price information. These are general or total prices and increases may not match changes in what you’ll pay.

If you have limited income and resources, your state may help you pay for Part A and/or Part B. You may also qualify for Extra Help to pay for your Medicare prescription drug coverage.