Every January, I talk with clients about their Medicare coverage, and I hear the same concern again and again: prescription prices feel shockingly high at the pharmacy. Sometimes drug manufacturers raise prices, and sometimes no generic option exists, but most of the time those aren’t the real reasons for the sticker shock.
Many seniors simply forget about the deductible built into their Part D drug plan. In 2026, most plans include a $615 standard deductible. To make things more confusing, that deductible doesn’t apply to every medication. Drug plans sort prescriptions into “tiers,” and only certain tiers—usually the higher-priced drugs—count toward the deductible.
The deductible resets every January, which often catches people off guard. Until you meet it, you pay the full retail cost of your medications. After you satisfy the deductible, your prices should drop. Still, it’s tough for anyone with expensive prescriptions to suddenly face more than $600 in costs during the first month of the year.
Many of you ask about plans with no deductible. They do exist, but their higher premiums can cancel out the savings. Some $0-deductible plans run $60-$100 per month, which often costs more than simply paying the deductible.
For 2026, Medicare has added a $2,100 cap on annual drug costs, as long as your medications appear on your plan’s formulary. You can also choose to spread your costs throughout the year with monthly payments if that helps your budget.
It’s important to review your drug plan every year to make sure it still fits your needs. You can compare plans on Medicare.gov, or we’re always happy to walk you through the options at no cost to you.
If you’d like to talk through your Medicare coverage questions, please give us a call at 800-750-2407. We’re always happy to help.
God Bless!
