Prescription drug costs can add up quickly—but Medicare Part D offers several ways to save, especially in 2026. Whether you take a few medications or manage multiple conditions, smart planning can keep your out-of-pocket costs low. The key is knowing how your drug coverage works—and how to make it work for you.
Let’s walk through simple, practical steps you can take this year to reduce what you pay at the pharmacy.
1. Review Your Drug Plan Every Year
Each year, your drug plan can change its:
- Premiums
- Deductibles
- Drug prices
- Pharmacy network
- Formulary (the list of covered drugs)
During Medicare’s Open Enrollment Period (October 15 – December 7), you can compare plans and switch if needed. Even if your prescriptions haven’t changed, your costs might.
Tip: Use the Medicare Plan Finder at Medicare.gov/plan-compare or get free help from a State Health Insurance Assistance Program (SHIP).
2. Know the 2026 Deductible and Spending Cap
Two key numbers to know this year:
- The Part D deductible is $615 in 2026 (up from $590 in 2025). You’ll pay this amount before your drug coverage kicks in.
- The out-of-pocket cap is $2,100 in 2026 (up from $2,000 in 2025). Once you reach this limit, you’ll pay nothing for covered drugs the rest of the year.
Both amounts are set by the federal government and apply to all standard Part D plans. Learn more about Medicare Part D changes.
3. Understand the Drug Formulary and Tier System
Each plan has a formulary—its list of covered drugs. Drugs are grouped into tiers that affect how much you pay. The following is an example of a Medicare drug plan’s tiers:
- Tier 1 (lowest copayment): most generic prescription drugs
- Tier 2 (medium copayment): preferred, brand-name prescription drugs
- Tier 3 (higher copayment): non-preferred, brand-name prescription drugs
- Specialty tier (highest copayment): very high cost prescription drugs
Some drugs have restrictions like:
- Prior authorization: Your doctor must get plan approval before it’s covered.
- Step therapy: You must try a lower-cost drug first.
- Quantity limits: Only a set amount is covered each time you fill it.
Tip: Always check your plan’s formulary to see where your drugs fall. Ask your doctor or pharmacist if a lower-cost alternative is available.
4. Choose Generics or Lower-Tier Alternatives
Generics work the same as brand-name drugs but cost far less. Whenever possible:
- Ask your doctor for a generic version of your medication.
- If no generic is available, ask if there’s a preferred drug in your plan’s formulary.
Switching to a lower-tier drug can make a big difference in your copay.
5. Use a Preferred Pharmacy
Plans often have preferred pharmacy networks where you pay less. If you go to a non-preferred pharmacy, your copays or coinsurance could be higher—even for the same drug.
Tip: Ask your plan for a list of preferred pharmacies or check online.
6. Consider Mail-Order Pharmacies
Many plans offer a discount when you fill a 90-day supply of your medications through a mail-order pharmacy. It can save you money—and trips to the pharmacy.
Bonus: You may pay fewer copays over the year with 90-day fills versus monthly refills.
7. Use the Medicare Prescription Payment Plan
Starting in 2025, Medicare introduced a Prescription Payment Plan, which continues in 2026. This allows you to spread your out-of-pocket drug costs over the year instead of paying all at once.
Good to know: You still only pay up to your plan’s out-of-pocket maximum—now capped at $2,100 in 2026.
8. Apply for Extra Help (Low-Income Subsidy)
If your income and resources are limited, you may qualify for Extra Help, which can lower your:
- Monthly premiums
- Annual deductibles
- Copays for prescriptions
More people are eligible in 2026 due to expanded qualifications. You can apply through SSA.gov or by calling Social Security.
9. Take Advantage of Cost Caps and Vaccine Coverage
Here’s what’s still available in 2026:
- Insulin copays are capped at $35/month through any Part D plan.
- Certain adult vaccines (like shingles, Tdap, pneumonia) are covered at no cost under Part D.
These benefits are built into all plans—you don’t have to do anything extra to get them.
10. Ask About Manufacturer or State Assistance Programs
If you still need help paying for your medications:
- Ask your doctor or pharmacist about manufacturer savings programs
- Check with your state to see if there’s a State Pharmaceutical Assistance Program (SPAP) available
These programs may offer discounts or copay help for people with high drug costs.
Ready to Save?
Cutting your Medicare drug costs isn’t about luck—it’s about knowing your options. Take time to compare plans, check formularies, and explore every opportunity to save. A little research now could mean hundreds in savings later.
Want help reviewing your options? Join a GetSetUp Medicare class to learn how to compare plans and lower your costs.