Maximize Your Medicare Coverage
Check formulary tiers, screen for Extra Help savings, understand your out-of-pocket cap, and find the lowest-cost pharmacies — all in one place.
$2,000
2025 Part D out-of-pocket cap
New for 2025 — no more catastrophic phase
$590
2025 max Part D deductible
Many plans have $0 deductible for Tier 1–2
5,300
Annual Extra Help savings
For qualifying low-income beneficiaries
67M+
Medicare beneficiaries
Including 54M+ on Part D drug coverage
Understanding Medicare Plan Types
Choose the right plan type before comparing specific plans.
Part D (PDP)
Standalone drug coverage added to Original Medicare
Medicare Advantage + Drug
All-in-one plan replacing Original Medicare
Medigap Supplement
Covers gaps in Original Medicare (no drug coverage)
The 2025 Medicare Prescription Payment Plan (M3P) lets you spread Part D costs across the year in monthly installments — no interest. Ask your plan about enrollment.
The $2,000 Out-of-Pocket Cap (2025)
Starting in 2025, Medicare Part D has a hard $2,000 annual out-of-pocket cap. Once you reach $2,000 in drug costs, you pay $0 for the rest of the year. This eliminates the old "donut hole" and catastrophic phase.
- Applies to all Part D plans including Medicare Advantage drug coverage
- Counts brand-name drugs, generics, and specialty drugs
- Manufacturer discounts count toward your cap
- Extra Help beneficiaries have even lower caps ($0–$103 deductible)
2025 Part D Phases
After $2,000: You pay $0
Formulary & Tier Lookup
Check what tier your drug is on and what restrictions apply under Medicare Part D.
Medicare Formulary Tier Checker
Check your drug's tier, copay, and restrictions under Medicare Part D
Tier definitions: Tier 1 (Preferred Generic, ~$0–$5) → Tier 2 (Generic, ~$5–$15) → Tier 3 (Preferred Brand, ~$35–$47) → Tier 4 (Non-Preferred, ~$80–$100) → Tier 5 (Specialty, 25–33% coinsurance). Actual tiers vary by plan.
Extra Help / Low-Income Subsidy Screener
Medicare Extra Help pays most of your Part D premium, deductible, and copays. An estimated 3 million eligible people are not enrolled. Check your eligibility in 30 seconds.
Medicare Extra Help Pre-Screener
Low-Income Subsidy (LIS) — saves up to $5,300/year on Part D
Network Pharmacy Strategy
Where you fill your prescription can change your copay by 50–80%.
Preferred Network Pharmacy
Lowest copay
Plans designate certain pharmacies as "preferred" with lower copays. CVS, Walgreens, and Walmart are often preferred.
Mail-Order Pharmacy
90-day supply savings
Mail-order pharmacies typically offer 90-day supplies for the price of a 60-day supply. Best for maintenance medications.
Out-of-Network Pharmacy
Highest cost
Out-of-network pharmacies may not be covered or may charge significantly more. Always verify network status before filling.
Ready to Compare Actual Plans?
The CMS Medicare Plan Finder shows every plan available in your zip code with exact premiums, deductibles, and drug costs.