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How Part D Works

Medicare Part D coverage helps pay for your prescription drugs

Part D helps cover the cost of prescription drugs, but your costs change throughout the year, depending on how much you and your plan have spent. That’s why coverage is divided into phases — each with different rules for what you pay.

 

The 3 phases of coverage work like this in 2026:

 

Phase 1: Yearly Deductible Phase

You begin this payment phase when you fill your first prescription of the year. You pay the total cost of your drugs until you've met your plan's annual deductible, if applicable. Once you've met your annual deductible, you move into the Initial Coverage phase.


Phase 2: Initial Coverage

During this phase, you pay copayments and/or coinsurance until your out-of-pocket costs reach $2,100 in 2026. If you meet this, you will move in the Catastrophic Coverage phase. 


Phase 3: Catastrophic Coverage

If you reach this phase, you no longer pay any copays or coinsurance for your Part D drugs for the rest of the calendar year. 

 

Medicare Prescription Payment Plan 

The Medicare Prescription Payment Plan (M3P) is a payment option that is designed to help manage your out-of-pocket drug costs by spreading them across the calendar yar (January - December). Because drug costs are spread out over the remaining months in the year, those with high drug costs early in the year may benefit the most from this option. This payment option might help you manage your monthly expenses, but it doesn't save you money or lower your drug costs. Learn More >

 

How Part D Works- Did you Know?

Did You Know?

The best time to enroll in a Medicare Prescription Drug Plan (PDP) like BlueRx is when you are first eligible for Medicare. If you delay your enrollment in Part D beyond your Initial Enrollment Period — and you don’t have “creditable coverage” as good as the Medicare standard benefit design — you may pay a penalty for late enrollment if you decide you want this coverage later.


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