If you recently turned 65 or will be soon, Medicare costs and plans may be on your mind.
Medicare requires that all enrollees have prescription drug coverage, and most people who enroll in Medicare opt for some form of it, either through a Medicare Advantage Plan or Medicare Part D. Both of these options are written by private companies and are approved, but not funded, by the federal government. You pay a premium to the provider, which helps cover your prescription drug costs. In 2019, 45 million of the more than 60 million people covered by Medicare were enrolled in Part D plans, making it the preferred choice for prescription coverage. (Part D includes only prescription drug coverage; dental, vision, and hearing coverage are not included.)
Every Part D plan meets specific Medicare rules about what type of drugs must be covered, and every prescription drug plan will have a formulary, which is a list of medications, in three tiers. The lower the tier, the lower the cost for the medication. The highest-tier drugs, often known by their brand names, are the most expensive. An example of a brand name drug is the diabetes treatment medication Januvia.
Before you sign up, it’s important to shop carefully for Medicare Part D because you could end up paying more than you have to for the prescription drugs you require.
You’ll want to give yourself time to evaluate your Medicare Part D options and choose a plan that works for your budget, covers the prescriptions you need, and works with your preferred local or online pharmacy.
The Best Medicare Part D Providers of 2020
Humana: Best Overall
Three plans to meet your needs
CMS Star Rating of 4
Lowest premiums in 47 states plus Washington, D.C.
Three mobile apps
Humana Value Rx Plan PDP may not serve all areas
The site is slightly difficult to navigate
Preferred pricing available only through Walmart and Sam’s Club or online
One of the most well-known health insurance providers, Humana has more than 13 million members nationwide. Humana earned a 4-star rating from the Centers for Medicare & Medicaid Services (CMS) and has strong financial backing.
The Humana Walmart Value Rx Plan has an affordable premium of just $13.20 per month, with no deductible on tier 1 and tier 2 medications. Tier 1 medications typically encompass preferred generics, (for example ibuprofen 400 mg), while tier 2 drugs include generics that are not part of Humana’s “preferred” network. Metformin, for instance, is a tier 1 drug for diabetes while Invokana is tier 2 or tier 3, depending on the plan.
The Humana Premier Rx Plan also has no deductible, but premiums range from $51.20 to $69.10, depending on the state. Either plan can be a good value for people with only a few prescriptions each month to fill.
The Basic Rx Plan has extremely low copays after the $435 annual deductible, making it better for people with expensive prescriptions.
The company offers a wide range of useful member services and apps, including the Go365 fitness app, the MyHumana app that puts your health information right at your fingertips, and the Humana Pharmacy app, which allows you to manage your prescriptions from your mobile device.
Overall, we selected Humana for its industry reputation, the depth of its member programs, and two plans with affordable premiums that also include no deductibles on tier 1 and tier 2 drugs.
Cigna: Best Overall, Runner-up
Cigna may not have the lowest premiums of the plans we reviewed, but its easy-to-navigate website, three choices in Medicare Plan D plans, and long-term financial stability puts it near the top of our list for best Medicare Plan D health insurance providers. Additionally, it has an AM Best rating of A, signifying financial stability.
Easy to compare plans online
Prescription plans available in all 50 states
Comprehensive website with resources for Medicare recipients
Three mobile apps allowing you to manage your policy, search for prescription medications, and manage your health from anywhere
3.5-star CMS Rating for 2020
Rx Secure has high premiums and a high deductible
Cigna offers three choices in Medicare Part D plans:
- Cigna-HealthSpring Rx Secure
- Cigna-HealthSpring Rx Secure-Essential
- Cigna-HealthSpring Rx Secure-Extra
The Rx Secure plan has a $435 deductible. If you order through the company's mail-order pharmacy, you can save with copays as low as $0 on tier 1 drugs like metformin and naproxen.
The Secure-Essential plan offers no deductible on tier 1 and tier 2 drugs, with no copay for tier 1 drugs ordered through preferred mail-order pharmacies. With monthly premiums listed at just $22.20, this may be one of the most affordable plans available. The Secure-Extra plan has the lowest deductible of the three offerings ($100), with a higher monthly premium of $74.40.
No matter which plan you choose, the myCigna mobile app makes it easy to manage your prescriptions from your mobile device and order medications for home delivery.
The company’s financial stability is exemplified by its No. 13 ranking on the Fortune 500 list.
You can buy your plan online or call to speak with a representative for help. The website offers robust resources, including videos and articles, for anyone with questions about Medicare in general or which plan they should purchase.
AARP/UnitedHealthcare: Best Online User Experience
Easy-to-navigate website packed with resources
Easy to compare plans online
Affordable premiums, and two plans with $0 deductibles
Two apps make it easy to manage your health insurance and your health
Will only get preferred pricing at Walgreens and Duane Reade
High premium on the Preferred Plan
We chose UnitedHealthcare because it's easy to choose from the three available plans on its website, outlining premiums, deductibles, and copays on drugs in different tiers in an easy-to-read chart.
Additionally, the plan is offered by the American Association of Retired Persons (AARP), exemplifying a solid reputation.
UnitedHealthcare’s Medicare Part D plan is one of the more costly on our list, but it's worth it for the value it provides and the level of customer service. With a 5-star CMS rating for customer service and several awards from top publications, UnitedHealthcare offers premier service that starts with an easy-to-navigate website.
The three plans are offered through AARP:
- AARP Medicare Rx Walgreens
- AARP Medicare Rx Preferred
- AARP Medicare Rx Saver Plus
The Walgreens plan has a $0 deductible on tier 1 drugs, and no copay if you fill your prescriptions at Walgreens, all for a monthly premium of $36.60. Meanwhile, the Preferred Plan, with no deductible and an $85.60 monthly premium, has reasonable pricing on tier 3, 4, and 5 drugs, starting as low as one-third of the price. Some other plans split the costs for top-tier drugs evenly with the customer.
The Saver Plus plan has a $435 deductible with a monthly premium of $63.40, with only a $1 copay on tier 1 drugs such as meloxicam and amoxicillin.
UnitedHealthcare offers the Health4Me app to track your prescriptions, store digital copies of your card, and more. The OptumRx app is designed by UnitedHealthcare for those who order medications through the provider’s preferred online pharmacy.
The company makes it easy to find an agent in your area to work with in-person, enroll directly online, or call to speak to a representative between 8 a.m. and 8 p.m., seven days a week. It also offers a free online Medicare guide to help you explore your options.
Wellcare: Best for Low Premiums
Eight different plans available
Low-priced plans with no deductible
Wealth of resources on website
Affordable plans starting at $14.20 per month
Only available in 32 states
The mobile app, StayWell, isn’t very robust
Website difficult to navigate
Preferred pharmacy is CVS, which may not be available in all areas
Headquartered in Tampa, Florida, WellCare Health Plans, Inc. serves 6.4 million members. We included it in our best Medicare Part D Plans because of its choice of eight different prescription drug plans, many of which are extremely affordable.
The Wellcare Wellness Rx plan has copays starting at $0 and a monthly premium of just $14.20. Best of all, there’s a $0 deductible on tier 1 and tier 2 drugs on this plan, including some forms of penicillin. You’d be hard-pressed to find more affordable prescription drug coverage with no deductible on tier 1 and 2 drugs.
The deductible for tiers 3, 4, and 5 is $435. Examples of tier 3 drugs include doxycycline, while tetracycline is a tier 4 drug.
Likewise, Wellcare Value Script has no deductible on tier 1 and tier 2 drugs. The difference in these plans is the formulary, so be sure to review the plans carefully to see if it covers your choice of drugs.
The WellCare Medicare Rx Value Plus is the priciest of the plans, with a monthly premium of $74.60, but there is no deductible for drugs on any tier.
If you don’t have a CVS Caremark pharmacy near you, you’ll pay a copay of $5 or more, depending on the drug's tier.
Wellcare’s website does not offer all the bells and whistles of other top providers. It is scant on resources and tricky to navigate. The company only has one mobile app that allows basic functions like storing a digital copy of your Medicare card. It’s good for offering plans to those who use tier 1 and tier 2 drugs or who just need prescription drug coverage to avoid penalties.
If you choose one of these low-cost plans and later require medications that have a deductible, you can change plans without penalty during a Medicare enrollment period.
Aetna: Best for No Deductible
No deductible on either plan
Online enrollment available
SilverScript Choice is available in all 50 states
High CMS ratings
SilverScript Plus not available in Alaska
Higher premiums than some competitors
Aetna offers two Medicare D plans: SilverScript Choice and SilverScript Plus. The SilverScript Choice plan has no deductible for drug tiers 1 and 2, and a relatively low $290 deductible for drugs in tiers 3 through 5. A monthly premium of just $34.80 makes the SilverScript Choice plan one of the most affordable that's available in all 50 states. There are no copays on tier 1 drugs and $1 copays on tier 2 drugs.
The SilverScript Plus plan has no deductible at all, and copays of just $2 on tier 2 drugs. You’ll pay $91.20 per month for the plan, so it makes sense to do the math on your prescription costs.
Aetna works with a network of 65,000 pharmacies, with CVS and CVS Caremark being the preferred providers. Finding a pharmacy and comparing medication costs online is easy. By signing up for a CVS Caremark account, you can set up automatic premium payments, check the formulary, get accurate prescription pricing, and find options to save money on your prescription drugs.
Aetna has high CMS ratings of 4 stars overall for its Medicare Plan D coverage, and 5 stars for its drug plan customer service.
How to Shop and Compare the Best Medicare Part D Plans
Follow these steps to help the process go smoothly:
Medicare has special rules about when you can enroll in a drug plan. Your Initial Medicare Enrollment Period begins three months before you turn 65 and ends three months after your 65th birthday. You can also enroll during the General Enrollment Period, from January 1–March 31, or the Open Enrollment Period, from October 15–December 7.
You could pay a lifetime penalty if you opt out of prescription drug coverage during your initial enrollment period and decide to add Part D or Medicare Advantage more than 63 days after your enrollment period ends. The penalty rises the longer you go without coverage, so it pays to plan ahead.
Step 2: See Which Medicare Part D Plans Are Available in Your Area
Shop online for a Medicare policy, including Medicare D, at Medicare.gov. When you visit the site, you don’t need to log in, but you will have to enter your ZIP code for accurate pricing.
Step 3: Make a List of All the Prescriptions You Currently Take
It’s important to research which providers cover those prescriptions and how much they cost if you don’t meet your deductible. Deductibles vary based on your plan.
The prescriptions covered by a Part D plan are listed in the provider’s formulary. A formulary is a list of medications, including generics and brand names, covered by your insurance. For example, common antibiotics like penicillin, or medications for heart health such as lisinopril, are often available as generic options.
As long as you already have a Medicare Part C or Part D plan in place, you can always shop around during the Open Enrollment or General Enrollment periods for one that better meets your needs and budget.
Step 4: Compare Prices for Your Medications
Checking the cost for your medications isn’t the only consideration. In addition, see where your prescriptions are on the plan formulary, You’ll also want to evaluate the monthly premium for your plan. The premium should be affordable to you relative to what you may pay for your medicines.
Step 5: Consider Getting Another Opinion
State Health Insurance Assistance Programs offer free counseling for individuals enrolling in Medicare for the first time or changing their plans.
Similarly, insurance brokers can talk you through the analysis to determine which plan is best for you. It does not cost you any more to purchase Medicare through a broker and, in fact, it could save you money because brokers have relationships with carrier partners and may be able to get you more favorable options.
Just make sure you’re getting the full picture, and that the agency works with multiple carriers so you have a full range of choices.
Websites like medicarerights.org also provide unbiased guidance.
Step 5: Sign Up
Your health insurance broker or your carrier of choice can help you. Alternatively, you can work with a professional through Medicare.gov once you’ve made your selection on the website.
How We Chose the Best Medicare Part D Companies
We looked at multiple plans from most of the major Medicare Part D providers, entering the same location into Medicare.gov to view our choices. Based on the offerings, we then visited the website for each of the best providers. Overall, we evaluated more than 30 plans from eight providers.
We evaluated the user experience on each site, the availability of a mobile app, pricing, coverage, financial stability, Medicare Star Ratings, and availability across the U.S. We looked for companies with high ratings, few customer complaints, widespread availability, and reasonable pricing across prescription medicine tiers 1 through 5.
Is Medicare Part D Less Expensive Than Medicare Advantage, for Prescription Costs?
Medicare Advantage, sometimes called Medicare Part C, bundles all your Medicare benefits under a single plan from a private insurance company. Medicare D, on the other hand, only offers prescription coverage.
Depending on the tiers of prescription medications, copays might range from $0 for a generic medication up to $25 on Part D.
We ran the numbers on a few Medicare Advantage plans available in New York and found that prescription drug coverage varied widely, depending on the plan and the pharmacy. The EmblemHealth VIP Value HMO quoted a total price of $14.55 (before the $295 deductible) for three common medications used for type 2 diabetes, high blood pressure, and high cholesterol: metformin, Lovastatin, and Metoprolol tartrate.
Humana Gold Plus quoted the same prescriptions as ranging from $8.91 to $18.50, monthly, depending on where the prescriptions were filled.
Will Medicare Part D Cover a COVID-19 or Flu Vaccine?
Medicare Part D does not cover flu vaccines. Medicare Part B may cover one flu shot per season through an approved health care provider.
However, Medicare Part D will cover a COVID-19 vaccine, according to the Coronavirus Aid, Relief, and Economic Security Act.
Does a Medicare Advantage Plan Cover Prescriptions?
Not every Medicare Advantage plan covers prescriptions, but most allow you to add prescription coverage as an option. Medicare Advantage covers everything Medicare Parts A and B cover. Medicare Part D only covers prescription drugs.
What Does a Medicare Advantage Plan With Prescription Coverage Typically Cost vs. Medicare Part D?
Since both Medicare Advantage and Part D are both written by private insurers, premiums and prescription costs vary widely. In 2020, the average base premium for Medicare Part D was $32.74 per month.
On the other hand, Medicare Advantage plans may start as low as $0 per month. The average plan costs around $23 per month with prescription drug coverage available at an additional cost.
What If I Want to Change My Medicare Advantage Plan to Medicare Part D?
You can switch from a Medicare Advantage plan to Medicare part D during Medicare’s General Enrollment Period, from January 1 through March 31 each year. If you miss that enrollment period, you can sign up during the Open Enrollment Period, from October 15 through December 7.
If you have special circumstances, you may be eligible to change your plan at other times. These circumstances include, but aren’t limited to:
- Moving to a new address
- No longer qualifying for Medicaid
- Losing Medicare coverage through your provider for any reason
"An Overview of the Medicare Part D Prescription Drug Benefit." Accessed September 16, 2020.
"What Medicare Part D drug plans cover." Accessed September 17, 2020.
Tufts Health Plan. "Massachusetts Commercial Formulary Prescription Drug List by Tier."