Types of AARP Medicare Part D Plans

AARP will likely offer two main types of Medicare Part D plans that could cater to different needs: standalone prescription drug plans (PDPs) and Medicare Advantage plans that may include prescription drug coverage.

Standalone PDPs will likely focus solely on prescription drug coverage, possibly making them a suitable choice for individuals who already have health insurance coverage through Original Medicare or a Medigap plan.

On the other hand, some Medicare Advantage plans may combine health care and prescription drug coverage, possibly providing a more integrated approach to health insurance coverage.

Potential Features of AARP Medicare Rx Preferred Plan

The AARP Medicare Rx Preferred plan might stand out for its extensive drug coverage and broad pharmacy network. This plan will likely cover a comprehensive formulary, possibly ensuring that a wide range of medications may be accessible to its members.

One of the potential advantages of the AARP Medicare Rx Preferred plan might be the elimination of the annual prescription deductible, which could mean members may start saving on their medications right away. Additionally, copays for preferred generic drugs at a preferred pharmacy may be as low as $5 for a 30-day supply, possibly making it an economical choice for many seniors.

For specialty drugs, the cost share will likely be about 33% of the drug’s price at both preferred and standard pharmacies, possibly ensuring that even high-cost medications may be more affordable. These potential features could make the AARP Medicare Rx Preferred plan a robust option for comprehensive prescription drug coverage.

Costs Associated with AARP Medicare Part D Plans

Understanding the potential costs associated with AARP Medicare Part D plans will likely be crucial for managing your healthcare budget effectively. Some plans may involve various expenses, such as:

• premiums
• deductibles
• copayments
• coinsurance

The monthly premium will likely act as the fee for enrollment in a Part D plan, and higher premiums could correlate with better coverage. Other major cost components might include:

• Annual deductible: The predetermined amount that must be paid out-of-pocket before coverage begins; changes to these costs may arise periodically.
• Copayments: Fixed fees paid for each prescription, which might vary based on the drug tier classification.
• Coinsurance: Requires the patient to pay a percentage of the drug cost, which may differ between plans.

Individuals with limited income could potentially benefit from the Extra Help program, which may help reduce certain Medicare Part D costs, such as deductibles and copays. Eligibility for this program will likely be determined based on the individual’s income and resources, possibly making it a valuable resource for those who qualify.

How to Choose the Right AARP Medicare Part D Plan

Choosing the right AARP Medicare Part D plan will likely require careful consideration of your medication needs. Prioritize coverage for your medications to help minimize out-of-pocket expenses. Utilizing the Plan Finder Tool on this website to help assess which plans might include your prescriptions in their formularies.

Additionally, evaluate if your preferred pharmacies may be part of the plan’s network, as this could potentially affect the cost of your medications. By comparing different plans based on premiums, deductibles, and medication costs, you could potentially save money and select the best plan for your situation.

Enrollment Process for AARP Medicare Part D Plans

Enrolling in an AARP Medicare Part D plan is a straightforward process, with the open enrollment period running from October 15 to December 7 each year. During this time, you can switch your Medicare Part D plan to better meet your needs.

Special circumstances, such as moving out of a nursing home or if your current plan is no longer contracted with Medicare, allow you to join or switch Part D plans outside the open enrollment period. Eligibility for AARP Medicare Part D plans typically requires individuals to be enrolled in Medicare Part A and/or Part B.

AARP provides support through the State Health Insurance Assistance Program (SHIP) for AARP members needing assistance with the enrollment process. This program provides personalized guidance to help you navigate the complexities of Medicare enrollment.

To enroll, call one of our licensed agents at 1-866-930-4039 (TTY 711) Mon-Fri: 8am-8pm EST.

Possible Changes to AARP Medicare Part D Plans in 2026

The year 2026 might bring several changes to AARP Medicare Part D plans due to the Inflation Reduction Act. One of the potential changes might be the introduction of an approximate $2,000 out-of-pocket maximum, which could help cap annual medication expenses for enrollees.

Additionally, the possible elimination of the coverage gap, commonly known as the ‘donut hole,’ might mean beneficiaries may experience consistent cost-sharing throughout the year.

These potential changes will likely be designed to simplify the initial coverage stage and potentially reduce certain out-of-pocket costs for prescription drugs, possibly leading to more coverage, catastrophic coverage, and predictable expenses for members.

Potential Benefits of Using a Preferred Network Pharmacy

Using a preferred network pharmacy could offer numerous benefits, such as:

• Lower copayments for prescriptions compared to non-network options.
• Agreements with insurance providers, which may offer discounted medication prices.

Preferred network pharmacies will likely be conveniently located within communities, possibly providing easier access to medications.

For those managing diabetes, preferred network pharmacies may also offer insulin with a copay of about $35, possibly making essential medications more affordable. Utilizing a preferred network pharmacy may also help reduce certain prescription drug costs and enhance your overall healthcare experience.

Possible Restrictions and Limitations

AARP Medicare Part D plans might impose formulary restrictions that could limit coverage for certain brand-name medications, which might require enrollees to verify if their prescribed drugs are included in the plan’s formulary of covered drugs. For instance:

• Formulary restrictions might limit coverage for certain medications.
• Enrollees must verify if their prescribed drugs are on the plan’s list of covered medications.
• Prior authorization may be required for some medications.
• Patients may need to obtain approval from their plan before the medication is covered.

Additionally, not all plans may utilize step therapy protocols, which might mandate that patients try less expensive options before being approved for more costly medications. Quantity limits may also be imposed on certain drugs, possibly capping the amount covered over a defined period to enhance safety and control costs.

Financial Assistance Programs

The Extra Help program will likely be designed to aid low-income individuals in managing their prescription drug costs under Medicare Part D. This program could potentially reduce the costs of some premiums, deductibles, and copayments for those who qualify, possibly making it a valuable resource for eligible individuals.

Recipients of financial assistance through the Extra Help program could have the flexibility to change Part D plans quarterly during the first three quarters of the year. This option may allow beneficiaries to adjust their coverage as needed to better manage their medication expenses.