A Guide to Managing Your 2026 Medicare Part D Plan

The start of a new year often brings changes, including updates to your Medicare Part D prescription drug coverage. If you selected a new plan during last fall’s Annual Enrollment Period (AEP), your coverage is now active. While this can mean better savings or improved benefits, it can also involve adjusting to new costs, pharmacies, and formularies.

At Local Medicare Specialists, we understand that navigating a new Part D plan can feel overwhelming. This guide breaks down key steps to help you manage your prescription coverage effectively throughout the year.

Review Your Plan Materials

When your new Part D plan took effect in January, your insurance provider should have sent a packet including your Evidence of Coverage (EOC), Summary of Benefits, and formulary (a list of covered drugs).

Take time to review these carefully. Key items to check include:

• Monthly premium: The amount deducted or billed each month.

• Annual deductible: The out-of-pocket amount you pay before coverage begins.

• Drug tiers: Each medication is assigned a tier that determines your copay or coinsurance.

• Preferred pharmacies: Some pharmacies offer lower copays for plan members.

Pro Tip: Keep all your documents in one place for easy reference. Staying organized makes it much simpler to track coverage and costs throughout the year.

Confirm Your Pharmacy Network

The pharmacy you use can have a major impact on your out-of-pocket costs. Each Part D plan has a network of pharmacies, and some are labeled preferred, offering the lowest prices.

Check whether your regular pharmacy is included in your plan’s preferred network by:

• Visiting your plan’s website or app

• Calling customer service

• Asking your local pharmacist

If your pharmacy isn’t preferred, consider transferring prescriptions to a preferred location or using mail-order for maintenance medications. Even within the same network, prices may differ, so a quick comparison can save you money over time.

Verify Your Medications Are Covered

Every Part D plan has a formulary (a list of covered medications) and this list can change from year to year. Just because a drug was covered on your old plan doesn’t guarantee it’s included on your new one or in the same cost tier.

Check your plan’s formulary to confirm:

• Drug name (brand or generic)

• Tier level (often 1 to 5)

• Special requirements such as prior authorization, quantity limits, or step therapy

If a medication isn’t covered or has moved to a higher tier, discuss alternatives with your doctor or pharmacist to find a lower-cost or covered option. Catching issues early ensures you won’t experience gaps in treatment.

Set Up Online Access or a Mobile App

Most Part D plans offer online portals or mobile apps that make managing your prescription coverage easier. After creating an account, you can:

• Review your covered drugs and plan details

• Track claims and out-of-pocket spending

• Order refills or set up mail delivery

• Check EOB statements

• Receive alerts about formulary changes or price updates

Some tools even compare prices across local pharmacies or suggest lower-cost alternatives. Setting up access early helps you stay informed and avoid surprises throughout the year.

Know Where to Turn for Help

Questions can arise even with careful planning. Key contacts include:

• Your plan’s customer service: For coverage, claims, or billing questions

• Your pharmacist: For copay, refill, or prescription transfer guidance

• Local Medicare Specialists agents: We provide clear explanations of benefits, help you compare pharmacy options, and assist if your medications become more expensive

You don’t have to navigate Part D alone. Professional guidance can help you avoid unnecessary costs and get the most out of your plan.

Keep Track for Next Year

While it might feel early to think about next fall’s Annual Enrollment Period, keeping records now makes future decisions easier. You should track:

• Any changes to prescriptions

• Coverage or cost issues

• Satisfaction with your plan

When AEP comes around, you’ll have a clear record to decide whether to stay with your current plan or explore alternatives.

Making the Most of Your Part D Plan

Starting a new Medicare Part D plan may require some adjustment, but taking a few proactive steps can help you maximize benefits. Review your plan documents, confirm pharmacy networks, verify drug coverage, and take advantage of online tools.

At Local Medicare Specialists, we help Medicare beneficiaries understand their prescription drug coverage and make informed choices. If you have questions about your new plan or want to ensure you’re getting the best value, our licensed agents are ready to guide you.

Here’s to a year of well-managed prescriptions and peace of mind!