Medicare Part D provides outpatient prescription drug coverage to Medicare beneficiaries through private insurance plans. The 2026 Part D benefit includes the main,000 annual out-of-pocket spending cap enacted by the Inflation Reduction Act, eliminating the catastrophic coverage gap. Each Part D plan has its own formulary, but all must cover at least two drugs in every therapeutic category and all drugs in six protected classes.
Key Facts
Check Your Specific Plan's Formulary
Coverage varies by plan. Use our formulary checker tool to look up your exact copay and restrictions.
Open Formulary CheckerFrequently Asked Questions
The donut hole (coverage gap) has been effectively eliminated. Starting in 2025, the Inflation Reduction Act capped out-of-pocket Part D spending at main,000 per year. Once you hit that amount, your plan covers 100% of drug costs for the rest of the year. This continues in 2026.
Use the Medicare Plan Finder at medicare.gov. Enter your zip code, current medications, and preferred pharmacy. The tool compares estimated total annual costs across all available plans in your area, factoring in premiums, copays, and your specific drug list.
Plans can make formulary changes mid-year, but they must provide 30 to 60 days notice before removing a drug or moving it to a higher tier. You can request a formulary exception, and you have the right to continue receiving a removed drug during the transition period.
Related Resources
- Medicare Advantage Formulary 2026
- Humana Formulary 2026
- UnitedHealthcare Formulary 2026
- Eliquis cash price comparison on RxGrab
- Jardiance cash price comparison on RxGrab
- Entresto cash price comparison on RxGrab
- Insulin cash price comparison on RxGrab
- Atorvastatin cash price comparison on RxGrab
- Drug interaction checker tool
- Patient assistance program finder
Get Formulary and Coverage Updates
Subscribe to receive alerts on formulary changes, new drug approvals, and insurance coverage updates.