Why does the same prescription cost one person $5 and another $50? Often, it comes down to drug tiers.
Every Medicare Part D plan sorts its covered drugs into tiers on a list called a formulary. Lower tiers, mostly generics, usually cost the least. Higher tiers, including brand-name and specialty drugs, cost more. Here is the catch: the same drug can sit on different tiers in different plans, and formularies can change from year to year.
In this second video of our Part D series, John Nelson walks through each tier, including where GLP-1 medications typically land and why drugs prescribed only for weight loss are generally treated differently.
Annual Enrollment runs October 15 through December 7. It is the right time to check where your medications fall on your 2027 plan.
Not affiliated with or endorsed by the federal Medicare program, Social Security, or any other government agency. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
You have probably seen ads for prescription discount programs. Can they replace your Medicare drug plan? No, and here is why that matters.
Outside savings programs can help with some higher-cost, brand-name, and specialty medications. But they are not creditable coverage, so they cannot replace a Medicare drug plan. Dropping your plan can trigger a lifetime late-enrollment penalty, and purchases made outside your plan generally do not count toward your deductible or out-of-pocket cap.
A few signs of a reputable program: it always requires a valid prescription from your doctor, and it works alongside your drug plan, not instead of it.
In the final video of our Part D series, John Nelson puts it all together: the 2027 premium change, drug tiers, working with your doctors, and where savings programs fit.
Disclosure: we may have affiliate relationships with some resources of the type discussed and may be compensated if you use them. General education only, not medical advice. Not affiliated with or endorsed by the federal Medicare program, Social Security, or any other government agency. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
Ever look at your pill organizer and wonder how you got here?
It happens to a lot of people. Different doctors prescribe different medications, and they do not always talk to each other. The result can be more side effects, more interactions, and higher costs.
In video 3 of our Part D series, John Nelson shares three steps that can lower your prescription costs and help you feel better:
Keep every medication on one list and share it with all your doctors.
Ask about generics wherever they are appropriate.
Review every medication with your doctor or pharmacist and ask why it is needed.
Never stop or change a medication on your own. Any change should come from your doctor.
Bonus tip: if you take several medications, ask your Part D plan about its Medication Therapy Management program, a pharmacist review at no additional charge for members who qualify.
General education only, not medical advice. Not affiliated with or endorsed by the federal Medicare program, Social Security, or any other government agency. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
Your Medicare Part D premium may be changing in 2027. Here is what you should know.
A temporary federal subsidy called the Part D Premium Stabilization Demonstration has helped hold down premiums for standalone Part D plans since 2025. The Centers for Medicare & Medicaid Services (CMS) is ending it after 2026, a year earlier than planned, which means some standalone drug plan premiums may rise next year.
The good news: the annual out-of-pocket cap on covered drugs stays in place, the insulin cost cap stays in place, and people who receive Extra Help are generally protected from this change.
The 2027 plans are already priced without the subsidy, so Annual Enrollment (October 15 through December 7) is the time to compare. What works for a neighbor may not suit you.
Not connected with or endorsed by the U.S. government or the federal Medicare program. We do not offer every plan available in your area. Currently we represent [#] organizations which offer [#] products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
Most people don’t pay much attention to what’s in the mail these days, but each September, those on Medicare should be on the lookout for an ANOC!
Each August and September, most insurance carriers send out an “Annual Notice of Change”, or ANOC, letter. It usually arrives by mail, and in rare cases by e-mail, followed by a mailed letter. This notice details any plan changes for the year ahead starting in January, and in recent years, it’s rare that a Medicare plan has no changes at all.
Regardless of whether you have a Medicare Supplement (Medigap) policy or a Medicare Advantage plan, changes usually come. However, the amount and severity of those changes depend on your plan type, where you live, and various company, market, and use factors that vary by insurer.
This letter matters because you and your care team decide whether to switch to a new insurance plan or stay where you are during the upcoming Annual Enrollment Period. It’s also important to us to know which plan you are on, what they want to change, and what is important to you that is changing and driving your need to explore other options.
So be on the lookout for this letter in our mailbox usually before September 30th each year. If you don’t receive it by then, contact your carrier or us to confirm it was sent and what might have happened, and to understand what to expect from that letter. We are always available to guide you through this letter and beyond:
Medicare uses letters twice, for two completely different things, and mixing them up is probably the single most common Medicare confusion there is.
Medicare Parts, A, B, C, and D, describe the actual pieces of your coverage. Part A is hospital care. Part B is doctor visits and outpatient care. Part C is Medicare Advantage, a private-plan alternative way to get your A and B (often bundled with D) through an insurance company instead of the government directly. Part D is prescription drug coverage.
Medigap Plans use an entirely different, unrelated lettering system, A, B, D, G, K, L, M, N, and a couple of others, for a completely different kind of product: supplemental insurance that only works alongside Original Medicare, helping cover the deductibles and coinsurance that Parts A and B leave you owing.
Here's the trip-up that catches almost everyone at some point: Medigap Plan D has nothing to do with drug coverage. It doesn't pay for a single prescription, that's still Part D's job, entirely separate. Same letter, two unrelated products.
One more thing worth knowing: every insurance company's Medigap Plan G has to offer the exact same standardized core benefits as every other company's Plan G, by law. The letter defines the coverage itself, only the price and the company behind it differ, which makes comparing Medigap genuinely simpler than comparing Medicare Advantage plans.
Which letter has confused you the most, a Part or a Medigap Plan? Tell us in the comments, you're definitely not the only one.
