ArcaMax

You may not be taking prescription drugs when you sign up for Medicare at age 65, or when your work coverage ends, but eventually you will need meds.

That’s why, immediately upon signing up for Medicare Part B, you must also sign up for Part D, which covers drugs, even if you are currently taking nothing stronger than Tylenol. If you wait, you’ll pay a significant monthly premium penalty later when you really need the coverage and the spending caps that Part D offers.

Even more important: You must review your Part D drug coverage every single year during open enrollment (which goes through December 7 this year). You need to do this even if you are taking the same drugs and even if you want to use the same pharmacy. Even if you liked your plan this year. You MUST review your coverage and be prepared to switch.

That’s because the plans change their pricing and the drugs they cover (their formularies) every year! What was a good deal for 2025 might be an expensive plan for 2026. And if you fail to do a review, you will be defaulted into last year’s plan — and could face an expensive surprise.

Here are key points you must know to get started and a way to get trusted help with Part D.

—Starting in 2026, insurance companies will not pay commissions to insurance agents for signing people up for Part D drug plans. (Last year, 2025, the commission was about $57 per plan sign-up.) So no one — with the one exception below — is going to hold your hand through the process of finding the best drug plan. It just doesn’t pay anymore.

—The good news is that in 2026, you will spend no more than $2,100 out-of-pocket for all of your covered drug expenses and monthly premiums (if any). The bad news is that not all of your prescribed drugs may be covered! If your drug isn’t covered, and your physician can’t find a generic substitute, then you are on the hook to pay in full.

—When searching for a new Part D drug plan for 2026, you must first update your drug list. (See below.) However, importantly, if you are prescribed a new drug during the coming year, there is no guarantee it will be covered by the plan that you are choosing now for 2026!

—If you are part of a Medicare Advantage plan that covers your drugs, you might also want to check the total costs of co-payments if any, and to be certain the plan formulary includes your drugs Since you can also switch Advantage Plans during open enrollment, the coverage — or lack of coverage — for your prescriptions might make you decide to change plans, assuming your physicians are in the new plan.

Start your search for the best (lowest cost, most comprehensive) drug plan at Medicare.gov. If you already have an account there, just log in. Or easily set up a new account. Once logged in, click on your account (the icon with your name in the top right corner), and then choose “My Saved Drugs.” You’ll see a list of last year’s prescriptions.

You can delete or add new drugs easily. Also update your list of preferred pharmacies.

Once your drug list is up to date, scroll to the “Start A New Plan Search” link on that page. Make sure you are looking at 2026 plans in your Zip code. That will bring up a list of your Part D choices for 2026, listed in order of total out-of pocket costs.

That’s the critical number: total drug and premium cost for 2026. That’s how you choose — based on your total cost, not on the monthly premium. Some plans could have a zero monthly premium, but a higher cost of drugs. Some plans may have a lower deductible than the 2026 max of $615, but a higher total cost of your prescriptions!

Also click on “View Drugs and Their Costs” for each plan. If you have expensive drugs, you may find that you’re paying a lot in the first few months of the year, until you meet the cap limitation. After that, your monthly cost will drop to zero.

If you’re confused, or before you decide you simply can’t afford your drugs, there is terrific help available. It’s a website called HEYMOE.com. (That stands for “hey — Medicare Open Enrollment.) Much like the Medicare.gov website, you enter your prescription drugs.

It will not only search for the lowest cost plan, but if a drug is uncovered or expensive, HeyMOE.com will automatically check for a GoodRx coupon and show it if one is available. No extra effort required.

And in complex cases (such as a drug that’s not covered or has no clear lower-cost alternative) an individual expert will look into whether there’s a biosimilar, a different formulation, or even a manufacturer assistance program that might help. The yearly fee is $30, and they’ll help you every year.

You can also get trusted plan advice at SHIPHelp.org — the State Health Insurance Program advisers.

Don’t give up and don’t be intimidated by this process. You absolutely must review your plan now — before you make an expensive mistake. That’s The Savage Truth.

(This is the final of a three-part series on Medicare open enrollment. The entire series can be found at TerrySavage.com.)

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(Terry Savage is a registered investment adviser and the author of four best-selling books, including “The Savage Truth on Money.” Terry responds to questions on her blog at TerrySavage.com.)

©2025 Terry Savage. Distributed by Tribune Content Agency, LLC.