Are all Part D drug plans the same?

Asked by: Florian Williamson  |  Last update: September 16, 2025
Score: 4.9/5 (55 votes)

Are Medicare Part D Plans All The Same? While prescription drug plans provide at least the standard level of coverage as it is defined by Medicare, they have the option to offer different combinations of coverage and cost sharing.

What is the most popular Part D drug plan?

The best Medicare Part D provider is Aetna. It has top ratings from the Centers for Medicare & Medicaid Services and affordable premiums. Other great providers include Wellcare and UnitedHealthcare.

Are Part D plans priced the same for everyone?

The monthly amount that Part D enrollees pay for individual Part D plans is different from the base beneficiary premium, and enrollees may see their premium increase by more than 6% (or less, or even decrease) if they stay in the same plan for 2025.

Do all Part D plans use the same formulary?

The government does not require every Part D plan to offer the same list of drugs. Instead, each drug plan will design a formulary, which is a list of drugs the plan will cover. All formularies must include coverage of certain drugs commonly prescribed to Medicare beneficiaries.

Are there any Medicare Part D plans without a donut hole?

Starting in 2025, Medicare no longer has a 'donut hole,' or coverage gap. In prior years, you paid up to 25% out of pocket for covered medications in the donut hole phase. Starting in 2025, once you reach the annual out-of-pocket cap ($2,000 in 2025), you're done paying out of pocket for the year.

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Can I avoid the donut hole?

While it is not possible to completely avoid the Donut Hole in Medicare Part D prescription drug coverage, beneficiaries can take steps to reduce the amount of time they spend in this coverage gap.

What is the maximum out-of-pocket for Part D in 2024?

Whether you're taking only brand-name drugs or a mix of brand-name and generic drugs, most people who reach the catastrophic coverage phase in 2024 will pay between $3,300 and $3,800 in out-of-pocket costs. In 2024, Mr. Alvarez takes $200,000 in Medicare Part D covered brand-name drugs.

How to compare Part D drug plans?

Look at the copays, coinsurance, monthly premiums, and deductibles across different plans, in addition to ensuring your medications are covered. Once you've found plans that cover the medications you use, compare the costs of those medicines.

Does AARP UnitedHealthcare have a Part D plan?

Medicare Part D Plans

Available to AARP members and non-members. Plans and pricing are on the UnitedHealthcare website.

What is a preferred pharmacy in Medicare Part D?

If your plan has “preferred in-network pharmacies,” they may save you money on your out-of-pocket drug costs (like a copayment or coinsurance) because they have agreed to charge less than other pharmacies in your plan's network.

What is the $2000 limit for Medicare Part D?

Thanks to the Inflation Reduction Act, in 2025 annual out-of-pocket costs will be capped at $2,000 for people with Medicare Part D.

Can I use GoodRx if I'm in the donut hole?

Key takeaways:

You may want to consider using GoodRx instead of Medicare when Medicare doesn't cover your medication, when you won't reach your annual deductible, or when you're in the coverage gap phase (“donut hole”) of your Medicare plan.

What are the top 5 medicare supplement plans?

💬 From our Nerds: What are the top five Medicare supplement plans? "Based on NerdWallet's Medigap rubric, I picked five best Medicare Supplement Insurance companies for 2025: AARP/UnitedHealthcare, Mutual of Omaha, State Farm, Anthem and Blue Cross Blue Shield.

What is the best medicare plan that covers everything for seniors?

Original Medicare with Medigap likely offers the most comprehensive coverage, but it may also be the most costly. A person can consider their income and how much they are able to spend before choosing a Medicare plan. Original Medicare with Medigap also offers a lot of flexibility when choosing a doctor or specialist.

Why are hospitals refusing Medicare Advantage plans?

Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. In 2023, Becker's began reporting on hospitals and health systems nationwide that dropped some or all of their Medicare Advantage contracts.

How much is SilverScript a month?

SilverScript Choice PDP includes:

A monthly plan premium of $53.60. Tier 1 drugs for no more than $5* copay at all network pharmacies. A $590 deductible applies to all tiers.

What is the disadvantage of UnitedHealthcare?

Cons About UnitedHealthcare Medicare Advantage

You may only have access to certain HMO or PPO plans in your area. And while UnitedHealthCare has competitive pricing, your location may only have access to plans with higher deductibles, more copays, and fewer additional benefits.

Why do people say not to get a Medicare Advantage plan?

Disadvantages of Medicare Advantage plans can include difficulty switching out of the plans later, restrictions on care access, limited provider networks, and limitations on extra benefits.

What Medicare Part D does not cover?

Medicare does not cover:
  • Drugs used to treat anorexia, weight loss, or weight gain. ...
  • Fertility drugs.
  • Drugs used for cosmetic purposes or hair growth. ...
  • Drugs that are only for the relief of cold or cough symptoms.
  • Drugs used to treat erectile dysfunction.

Are all Medicare Part D plans the same price?

You can find some Part D plans much cheaper and others much more expensive than that average. And since 2024, some Medicare Part D plans have $0 premiums. Medicare Part D premiums range from $0 to $190.80 per month in 2025 for stand-alone plans.

Who is the preferred pharmacy for UnitedHealthcare?

You may see the name Optum Rx on your prescription benefits. This is the UnitedHealthcare pharmacy service provider.

What are the 6 things Medicare doesn't cover?

Some of the items and services Medicare doesn't cover include:
  • Eye exams (for prescription eyeglasses)
  • Long-term care.
  • Cosmetic surgery.
  • Massage therapy.
  • Routine physical exams.
  • Hearing aids and exams for fitting them.

How do you qualify for $144 back from Medicare?

To be eligible for the Medicare Part B Giveback Benefit, you must:
  1. Be enrolled Original Medicare (Parts A and B)
  2. Pay your own Part B premium.
  3. Live in the service area of a plan that offers a Part B giveback.

Is the Medicare Part D donut hole going away in 2025?

In 2025, 0:43 the coverage gap, also called the donut hole, has been removed. 0:56 and catastrophic coverage stage. 1:02 for paying the full cost of their drugs until they reach this amount.

Can I buy a stand-alone prescription drug plan?

These are standalone plans that can be purchased through private insurance companies. PDPs provide coverage for prescription drugs and medications and may also cover some vaccines too. Original Medicare (Parts A & B) doesn't provide prescription drug coverage.