Prescription Drug Plan Review - HTA Insurance Services

Annual Enrollment Period

How to Review Your Prescription Drug Plan

Follow the steps below to enter your medications, review options and find the Part D plan that best fits your needs.

Before You Get Started

The standalone Part D shopping process has changed for 2027. Changes across the Part D market have limited how insurance agents are able to assist with standalone Part D plans.

As a result, most clients will review and enroll in their Part D plan through Medicare.gov using the resources below.

HTA is not offering routine Part D AEP review appointments like in prior years, so please complete the steps on this page before contacting HTA for Part D support.

Important 2027 Part D Plan Changes

Some Part D plans are seeing major changes for 2027, including plan terminations, automatic moves to new plans, and significant premium changes.

Watch this short video before deciding whether to keep or change your plan.

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Information to Gather

Before you begin, have these items nearby:

1. Your Medicare Card (You’ll need your Medicare Number and start date)
2. Your current Prescription Bottles
3. Name(s) of your Preferred Pharmacies

Tip: Using the exact medication name and dosage helps Medicare.gov estimate the most accurate costs.

Step 1: Log In & Enter Your Medications

Before comparing plans, make sure your Medicare.gov account is ready and your information is current.

Log in to your Medicare.gov account
Don’t have an account? Create one
Enter each medication exactly as it appears on your prescription bottle
Confirm or update your preferred pharmacy

Important Tip:

Use your prescription bottles while entering medications. Small differences in dosage, quantity, or frequency can affect the cost estimates Medicare.gov shows you.

Watch: How to Add Prescriptions and Pharmacies in Medicare.gov

Step 2: Compare Your Part D Options

Once your medications and pharmacy are entered, Medicare.gov will show the available Part D plans.

When comparing plans, review:

Total Drug & Premium Cost
Monthly Premium & Deductible
Drug coverage, Prescription copays, or coinsurance
Preferred pharmacy

Important Tip: Do not choose a plan based on monthly premium alone.

Medicare.gov calculates a total drug and premium cost based on your medications and pharmacy. Use that number when comparing your options.

Watch: How to Review and Compare Plans on Medicare.gov

Step 3: Review & Decide

Keeping Your Current Plan?

No action is needed.

If your current plan is still a good fit for 2027 and is continuing next year, it will renew automatically.

Changing Plans?

Enroll through Medicare.gov between October 15 and December 7.

Once your new enrollment is submitted, your new coverage will begin January 1, and your current plan will end automatically.

No separate cancellation is needed.

Have Questions About a Plan?

If you are able to use Medicare.gov but have questions about a specific Part D plan:

Check the FAQs below for common Part D questions
If you are keeping your current plan, contact your current insurance company
If you are considering a new plan, contact that insurance company directly
The plan can explain how the coverage works, including prescription coverage, copays, pharmacy networks, prior authorization, and other plan rules
If you would like help comparing your Part D options, you can also call 1-800-MEDICARE

Still Need Help?

Please start with the steps and resources above.

If you are unable to navigate Medicare.gov, please call HTA at 610.430.6650. We will have limited Part D support available for clients who need additional assistance.

Medicare Supplement Reminder

Medicare Supplement plans are not part of AEP.

You do not need to review or change your Medicare Supplement plan just because AEP is happening.

HTA will continue to help you review your Medicare Supplement coverage around your policy renewal.

We’ll send you a reminder 30 days before your renewal so you can decide whether a review makes sense.

If you received a rate increase or are approaching your policy renewal, learn when it may make sense to review your Medicare Supplement coverage.

Learn the Best Time to Review Your Medicare Supplement Plan

Common Medicare.gov Questions

While Entering your Medications

Enter medications exactly as prescribed
How should I enter “as needed” medications?
Medicare.gov may not calculate costs accurately for medications you only fill occasionally, and the “every 2 months” and “every 6 months” options often produce misleading estimates.

To get a more accurate cost per fill:

If you fill a medication 4–5+ times per year, enter it as monthly

If you fill a medication 1-3 times per year, enter it as every 12 months

Example:
If you take a medication as needed and fill it a few times per year, entering it as monthly may increase the total annual cost shown—but it will give a more accurate estimate of your copay per fill.

Note: The total cost shown may not reflect what you actually spend, but this method helps you compare plans more accurately.
This is only a pricing tool—not a commitment

Adding a medication to Medicare.gov does not mean you will have to fill or pay for that prescription.

This tool is only used to estimate your costs. You are only charged for medications you actually fill at the pharmacy.
Your medication list is not reported to the insurance company.
What if I use GoodRx or pay cash?
You can still enter those prescriptions into Medicare.gov to see how each Part D plan would cover them.

This helps you compare:

Whether the drug is covered

The estimated copay

Any deductible

Any restrictions, such as prior authorization or quantity limits

You are not required to use your insurance for every prescription. At the pharmacy, you can ask whether the cost is lower through your Part D plan, GoodRx, or cash pricing.

Important: Prescriptions filled outside your Part D plan do not count toward your Part D deductible or annual out-of-pocket costs.

Tip: If a medication is expensive or taken regularly, enter it into Medicare.gov even if you sometimes use GoodRx.
What if my medication is an injection or infusion?
Some medications that are given in a doctor’s office, infusion center, or other outpatient setting may be covered under Medicare Part B instead of Part D.

Examples may include:

Prolia injections

Cortisone injections

Infusion treatments

These medications generally do not need to be entered when comparing Part D plans on Medicare.gov.
Should I enter over-the-counter medications?
I Take a GLP-1 Medication. Should I Add It to Medicare.gov?
It depends on why you take the medication.

Add your GLP-1 to Medicare.gov if it is prescribed for a condition that may be covered by Medicare Part D.

For example, some GLP-1 medications may be covered when prescribed for conditions such as Type 2 diabetes, sleep apnea, or certain other Medicare-covered medical conditions. Adding it allows Medicare.gov to show whether each Part D plan covers the medication and include the estimated cost in your comparison.

Do not add the GLP-1 to your Medicare.gov drug list if you take it only for weight loss or weight management.

Medicare Part D does not cover medications when they are prescribed solely for weight loss, so including it could make your Part D plan comparison confusing or inaccurate.

What about the Medicare GLP-1 Bridge?
Medicare has a separate GLP-1 Bridge program that may provide certain weight-management GLP-1 medications for $50 per month to people who qualify. The Bridge is separate from your Part D plan, so medications received through the Bridge should not be included when comparing your Part D plan costs on Medicare.gov.

Not sure which applies to you? Check with your prescribing doctor, your current drug plan, or call 1-800-MEDICARE before completing your Part D comparison.

When Comparing Plans

How do I know which Part D plan is the best fit for me?

There is not one Part D plan that is best for everyone. Focus on the plan that works best with your medications, preferred pharmacy, and expected total cost for the year.

Medicare.gov’s Total Drug + Premium Cost combines your estimated prescription costs and plan premiums into one number. A plan that covers your prescriptions and has a lower Total Drug + Premium Cost should be a top consideration when comparing your options.

Also review whether all of your medications are covered and whether any restrictions, such as prior authorization, quantity limits, or step therapy, apply
Your pharmacy choice affects your cost

The same prescription can cost differently depending on which pharmacy you use.

When comparing plans on Medicare.gov, check whether your preferred pharmacy is listed as preferred or standard, and compare the estimated costs at each pharmacy.

Tip: If you are flexible on pharmacy, compare a few options — changing pharmacies may lower your total prescription costs.
Deductibles and How They Work
Some Part D plans include a deductible, which is the amount you pay out-of-pocket before the plan begins covering certain medications.

However, some plans that have a deductible do not apply it to lower-tier medications (Tier 1 and/or Tier 2). This means:

You will typically pay just the copay for those medications

The deductible usually applies to higher-tier (brand-name) drugs

Because of this, having a deductible does not always mean higher overall costs, especially if most of your medications are lower-tier.
Drug tiers affect your cost
Each plan places medications into tiers (typically Tier 1–5), which determine how much you pay.

Tier 1-2 : Lower-tier drugs (usually generics) have lower copays

Tier 3-5 : Higher-tier drugs (brand-name or specialty) have higher costs

Two plans may cover the same medication but place it in different tiers, which can significantly change your cost.

When comparing plans, check how your medications are categorized, as this directly impacts your total annual cost.
What if one of my medications is not covered?
First, double-check that the medication name, dosage, quantity, and frequency were entered correctly.

Some items are generally not covered by Medicare Part D, including:

Vitamins and supplements

Most over-the-counter medications, even if your doctor writes a prescription

Many compounded medications

If a regular prescription medication is not covered by the plan, you may want to:

Compare other Part D plans to see whether another plan covers it

Check whether the plan covers a similar alternative

Ask your doctor whether a covered alternative may be appropriate for you
What do prior authorization, quantity limits, and step therapy mean?
These are coverage rules that may apply to certain medications:

Prior Authorization: Your doctor may need to get approval from the plan before the medication is covered.

Quantity Limit: The plan may limit how much of a medication it will cover at one time or during a certain period.

Step Therapy: You may need to try a different medication first before the plan will cover the prescribed drug.

Medicare.gov may show these restrictions when you review plan details, so it is important to consider them along with cost.
Focus on the Total Drug and Premium Cost

When comparing Part D plans on Medicare.gov, don’t look at the monthly premium alone.

Medicare.gov estimates your total yearly cost based on your prescriptions, pharmacy, monthly premium, deductible, and expected drug costs.

A plan with a lower monthly premium may actually cost you more overall.

Tip: Use the Total Drug & Premium Cost to compare plans based on your actual medications and pharmacy.