Medicare Part D gives you access to prescription drug coverage, and several tools exist to help you understand your plan, find lower costs, and track your medications

Medicare Part D is the prescription drug benefit, and it works differently depending on which plan you choose and which pharmacy you use. The tools available to you fall into three main categories: tools run by Medicare itself, tools your insurance plan provides, and tools run by pharmacies and independent organisations. Knowing which tool does what saves time and prevents you from paying more than you need to.

Some tools help you compare plans before you sign up. Others help you find the lowest price for a specific medication right now. Still others track what you have already paid toward your deductible and out-of-pocket maximum. This article walks you through the real tools you can use today, what each one does, and when to reach for each one.

Key Takeaways

  • Medicare.gov's Plan Finder lets you compare Part D plans side by side and see what your specific medications will cost under each one.
  • Your insurance plan's website or customer service line can tell you whether a medication is covered, what tier it is on, and whether your doctor needs to request prior approval.
  • GoodRx, SingleCare, and similar discount programs show you cash prices at different pharmacies, even if you have Part D coverage.
  • The Extra Help program reduces your Part D costs if your income is below a certain threshold, and you can check whether you may have access to through Medicare.gov.
  • Your pharmacy's price-check tool at the register can show you whether paying cash is cheaper than using your insurance for that one fill.

Medicare.gov Plan Finder: Compare plans and see medication costs before you enroll

The Plan Finder on Medicare.gov is the official tool for comparing Part D plans. You enter your medications (including the dose and how often you take them), your preferred pharmacies, and your zip code. The tool then shows you every Part D plan available in your area, ranked by estimated yearly cost for your specific medications.

Plan Finder tells you the monthly premium, the deductible, the copay or coinsurance for each medication, and whether your doctor will need to request prior approval before the plan will cover a drug. You can compare up to three plans at once. This tool is most useful during the annual enrollment period (October 15 to December 7 each year), but you can use it anytime to see what plans cost.

To use Plan Finder, go to Medicare.gov, select "Find care providers and suppliers," then choose "Find prescription drug plans." You will need your Medicare number, but you do not need to log into your account. If you do not have your medications' exact names and doses handy, call your pharmacy or your doctor's office first — the more accurate your list, the more accurate your cost estimate.

Your Plan's Website and Customer Service: Check coverage and costs for a specific drug

Once you have chosen a Part D plan, that plan's website becomes your main tool for day-to-day questions. You can log in to see which drugs are covered, what tier each drug is on (tier 1 is usually cheapest, tier 5 is usually most expensive), and what your copay or coinsurance will be. You can also check whether your doctor needs to request prior approval or step therapy (trying a cheaper drug first).

If you cannot find the answer on the website, call the customer service number on the back of your insurance card. A representative can tell you the exact cost you will pay at your pharmacy, whether a generic version is available and cheaper, and whether a different medication in the same drug class might cost less. They can also tell you how much you have already paid toward your deductible and out-of-pocket maximum for the year.

Keep your plan's customer service number in your phone or on your refrigerator. Calling before you fill a prescription — especially for a new medication or a medication you have not filled in a while — takes five minutes and can save you money if the cost has changed or if a cheaper alternative exists.

Discount Programs like GoodRx and SingleCare: Find cash prices when insurance is not the cheapest option

Discount programs such as GoodRx, SingleCare, and RxSaver show you the cash price of a medication at different pharmacies in your area. You enter the drug name, dose, and quantity, and the tool shows you prices at CVS, Walgreens, Walmart, local independent pharmacies, and others. Prices vary by pharmacy and by whether you use a discount card or a coupon code.

These tools are free to use. You do not need to sign up or enter your insurance information. Sometimes the cash price (with a discount code) is lower than your Part D copay, especially for generic medications or for drugs on a higher tier. At the pharmacy register, you can ask the pharmacist to compare your insurance copay to the cash price and use whichever is lower.

read the GoodRx or SingleCare app to your phone, or use the website on a computer. You can also text a pharmacy directly to ask for a price. These tools work best for medications you take regularly, because you can check prices before each fill and switch pharmacies if a better price appears.

Extra Help: Reduce your Part D costs if your income qualifies

The Extra Help program (also called the Low-Income Subsidy) reduces your Part D premiums, deductibles, and copays if your income is at or below 150 percent of the federal poverty line. The income limit varies by year and by family size, but for 2024 it is roughly $1,500 per month for a single person and $2,000 per month for a married couple.

You can check whether you may have access to by going to Medicare.gov, selecting "Help paying prescription drug costs," and following the link to the Extra Help process. You can also call 1-800-MEDICARE (1-800-633-4227) and ask to speak with someone about Extra Help. If you may have access to, your costs drop significantly — you may pay zero dollars for generic drugs and small copays for brand-name drugs.

Extra Help is worth checking even if you think your income is too high, because the calculation includes certain deductions and the rules change each year. If you are already receiving Supplemental Security Income (SSI) or Medicaid, you are automatically enrolled in Extra Help and do not need to explore.

Your Pharmacy's Price-Check Tool: Compare your copay to the cash price at the register

Most major pharmacies (CVS, Walgreens, Walmart, Kroger, and others) have a tool at the register that shows your insurance copay and the cash price side by side. When the pharmacist rings up your prescription, ask them to show you both prices. If the cash price is lower, you can choose to pay cash instead of using your insurance.

This is especially useful for medications you take once or twice a year, or for generic drugs that cost only a few dollars. Paying cash does not count toward your Part D deductible or out-of-pocket maximum, so it only makes sense if the cash price is significantly lower than your copay.

Some pharmacies will also let you split a fill — for example, filling a 30-day supply with insurance and a 30-day supply with cash if one is cheaper. Ask your pharmacist whether your pharmacy allows this.

Medicare's Medication Therapy Management (MTM) Program: Free medication review if you take multiple drugs

If you take multiple medications and your Part D plan costs more than a certain amount per year (the threshold varies by plan), you may be enrolled automatically in Medication Therapy Management. A pharmacist or nurse will review all your medications with you, check for interactions, and suggest ways to simplify your regimen or reduce costs.

This service is free and confidential. You can do it over the phone, by video, or in person at your pharmacy. The pharmacist will give you a written summary of their recommendations and send a copy to your doctor. If you are enrolled and receive an invitation, take it — the review often uncovers medications you no longer need or cheaper alternatives you did not know about.

Frequently Asked Questions

Can I use a discount program like GoodRx if I have Part D coverage?

Yes. You can compare your Part D copay to the GoodRx or SingleCare price and use whichever is lower. Tell the pharmacist which one you want to use before they process the prescription. Using a discount program instead of insurance does not count toward your deductible or out-of-pocket maximum.

How do I know if my doctor needs to request prior approval for my medication?

Check your plan's website or call customer service and ask. You can also ask your doctor's office — they often know which medications require prior approval from your plan. If approval is needed, your doctor can usually request it in one business day, but it is better to find out before you try to fill the prescription.

What if I cannot afford my Part D copays?

Check whether you may have access to for Extra Help through Medicare.gov or by calling 1-800-MEDICARE. If you do not may have access to, ask your plan's customer service about patient information programs run by the drug manufacturer. Many pharmaceutical companies offer free or reduced-cost medications to people who cannot afford them.

Can I use Plan Finder to compare plans if I am not yet on Medicare?

No. Plan Finder is only for people already enrolled in Medicare Part A or Part B. If you are turning 65 soon, you can use Plan Finder once your Medicare coverage begins. Until then, contact your state health insurance counselor for information about prescription drug coverage options.

Does using a discount program hurt my credit or leave a record?

No. Discount programs like GoodRx and SingleCare are free, do not require a credit check, and do not create a record that affects your insurance or credit. They are straightforward a way to compare prices and get a coupon code at the pharmacy.