Prescription Savings Made simple

Christine's Corner

Medicare Part D helps cover the cost of prescription medications. These plans are offered by private insurance companies and are available either as a standalone prescription drug plan (PDP) that works alongside Original Medicare or as part of a Medicare Advantage plan (MAPD), which combines medical and prescription drug coverage in one plan.

Key Things to Remember

• Check the formulary (drug list): Your prescription must be included on your plan's drug list (formulary) to be covered.
• If your drug is not listed, your doctor can request a formulary exception.

New in Recent Years

• There is now a yearly out-of-pocket cap for covered prescription drugs.
• In 2026, the limit is $2,100. After that, you pay $0 for covered prescriptions for the remainder of the year.

If You Cannot Afford Your Medications

You have options:

• Step therapy: Try a lower-cost drug first. If it does not work, ask your doctor whether you qualify for an exception.
• Ask about Extra Help, a program that

If you have questions or need assistance, please contact SIH Second Act Medicare Counselor, Christine Thompson at christine.thompson@sih.net or call 618.457.5200 ext. 67856.