How Do You Compare Part D Drug Plans Each Year?

Enter your exact drugs, doses, and preferred pharmacy into the Medicare Plan Finder at medicare.gov during Annual Enrollment Period. Check each plan's formulary tier for your medications and confirm your pharmacy is in-network. Compare the estimated annual cost—premium plus out-of-pocket—because Part D plans can change formularies, premiums, and copays every year.

Why re-check Part D every year?

Plans may drop drugs from the formulary, move them to a higher tier, change copays, or exit your county entirely between plan years. Your own health can also shift—new prescriptions or dose changes mean last year's best plan may no longer deliver the lowest total cost.

Plans may drop drugs from the formulary, move them to a higher tier, change copays, or exit your county entirely between plan years. Your own health can also shift—new prescriptions or dose changes mean last year's best plan may no longer deliver the lowest total cost. CMS requires plans to mail an Annual Notice of Change by September 30, but you should still compare before Oct 15 using your current medication list to catch any formulary or network adjustments the notice may not highlight clearly.

What is a formulary tier?

A formulary tier groups medications by cost-sharing level; lower tiers carry smaller copays or coinsurance, while higher tiers (typically specialty drugs) cost more out-of-pocket. Most Part D plans use four to five tiers, and the same drug may land on Tier 2 in one plan and Tier 4 in another.

A formulary tier groups medications by cost-sharing level; lower tiers carry smaller copays or coinsurance, while higher tiers (typically specialty drugs) cost more out-of-pocket. Most Part D plans use four to five tiers, and the same drug may land on Tier 2 in one plan and Tier 4 in another.

• Tier 1 – preferred generics (lowest copay)
• Tier 2 – generics
• Tier 3 – preferred brand-name drugs
• Tier 4 – non-preferred or specialty brands
• Tier 5 – high-cost specialty drugs (often coinsurance)

Comparing tier placement is essential when estimating your annual cost, because a single tier jump can add hundreds of dollars per prescription.

Does your pharmacy choice change costs?

Yes; Part D plans contract with preferred and standard network pharmacies, and filling at a preferred location usually means lower copays for the same drug. Some plans also offer mail-order discounts for 90-day supplies, which can further reduce your annual spend.

Yes; Part D plans contract with preferred and standard network pharmacies, and filling at a preferred location usually means lower copays for the same drug. Some plans also offer mail-order discounts for 90-day supplies, which can further reduce your annual spend. If you use an out-of-network pharmacy, you may pay full retail and file for partial reimbursement, so confirm your local or mail pharmacy appears in the plan's directory before enrolling. Switching pharmacies mid-year to chase a lower copay is allowed, but easier if you verify network status during AEP.

How Affordable Medicare Quote handles this

Affordable Medicare Quote delivers exclusive Medicare live transfers, call backs, aged inventory, and raw data to licensed agents nationwide. Each lead type is filtered by your licensed states so you connect with seniors eligible to enroll or change coverage during the appropriate window.

Affordable Medicare Quote delivers exclusive Medicare live transfers, call backs, aged inventory, and raw data to licensed agents nationwide. Each lead type is filtered by your licensed states so you connect with seniors eligible to enroll or change coverage during the appropriate window. Because formularies and premiums reset every plan year, AEP and OEP create natural urgency for beneficiaries comparing Part D options, and our pipeline helps you reach those actively shopping before they commit elsewhere. You work with prospects who have already expressed interest in reviewing their coverage, so your time stays focused on helping them compare options rather than cold prospecting.

Frequently asked questions

Can you switch Part D plans outside of AEP?

Generally no, unless you qualify for a Special Enrollment Period—moving, losing other coverage, or dual-eligible status. Most beneficiaries change plans Oct 15–Dec 7 during AEP.

Do all Part D plans cover the same drugs?

No; each plan maintains its own formulary and tier structure. A drug covered on Tier 1 in Plan A might be Tier 4 or unlisted in Plan B.

What if my drug isn't on any formulary?

Ask your prescriber if a therapeutic alternative on the formulary works, or file a formulary exception request with the plan. Coverage is not guaranteed but may be approved with clinical justification.

Should you use the Plan Finder every year even if you like your current plan?

Yes; your current plan's formulary, premium, or network may change, and a competitor may offer better coverage for your exact medication list this year.

How accurate is the Plan Finder cost estimate?

It reflects the plan's published formulary and your entered drugs, but actual costs depend on dose changes, prior authorization, and which pharmacy you choose. Treat it as a planning tool, not a guarantee.

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