Part D and Its Three Stages
Learn how prescription drug coverage works: formularies, preferred pharmacies, and the three coverage stages (the "donut hole" gap was eliminated in 2025).
Part D helps with prescription drugs. Before choosing prescription drug coverage, review:
- Whether your medications are on the plan formulary.
- The drug tier.
- Prior authorization requirements.
- Step therapy requirements.
- Quantity limits.
- Preferred pharmacies.
- Mail order options.
Since 2025 there is no coverage gap ("donut hole"). Drug coverage has three stages: a deductible (if your plan has one), initial coverage, and catastrophic coverage once your out-of-pocket drug costs reach the yearly cap ($2,100 in 2026). Rules may change by year and plan.
Note: Medication costs should be verified before making a decision.
This guide is for general education only. Plan availability, benefits, costs, networks, medications, and eligibility may vary by county, plan, and individual situation. For a specific review, a licensed advisor must verify your information.