It’s easy to assume your Medicare drug plan (Part D) stays the same year to year, especially if your prescriptions haven’t changed. But it’s so important to review your Part D plan every year because they reset annually, and that means your premiums, copays, drug tiers, and pharmacy networks can all change beneath the surface.
If you simply “let it roll over,” you could start the next year with a surprise at the pharmacy counter. Some drug plans terminate, meaning they will not roll into the next year. If you don’t make a change, you will have no drug coverage the next year.
Why Do Part D Plans Change Every Year?
Part D drug plans are offered by private insurance companies that contract with Medicare. Each year, these companies adjust their:
- Formulary (list of covered drugs)
- Tier structures (how much you pay for certain drugs)
- Preferred pharmacy networks
- Monthly premiums and annual deductibles
These changes are how insurers manage costs, negotiate with drug manufacturers, and respond to new federal rules. It’s a normal part of how Part D works but it’s also why staying on top of your plan is critical.
How Changes Affect You
Even a small shift in your plan design can have a big financial impact. Watch for:
- Your medication being moved to a higher tier, meaning higher copays.
- Your pharmacy losing “preferred” status, which increases your costs per fill.
- Your drug being dropped altogether — requiring you to switch medications or pay full retail price.
- Premium and deductible increases, which can add up quickly if you’re on multiple prescriptions.
One Drug Change Can Cost a Retiree Thousands of Dollars
Every year I talk with folks who are shocked to learn their medication is going to cost more. Imagine you take a brand-name heart medication that’s always been on Tier 3 of your plan — with a $47 copay.
Next year, your plan reclassifies it to Tier 4 or removes it from the formulary. Suddenly, your copay could jump to several hundred dollars per month, or the drug may not be covered at all.
These shifts happen every year, and retirees often don’t notice until it’s too late. If you don’t make the change during the change window of October 15-December 7th, you are stuck in that plan for the whole next year. A quick review during open enrollment can literally save you thousands of dollars.
Questions to Ask Yourself During Medicare Open Enrollment
Adequate review requires more than looking at prescriptions. Before you renew your current plan, take a few minutes to think about your health, medications, and upcoming needs. Asking the right questions can help you choose a plan that fits your life for the year ahead.
Here are a few questions to start with:
- Have my prescriptions changed, or am I considering any new medications?
- Am I planning a surgery or medical procedure in the next year?
- Will I need rehabilitation, physical therapy, or ongoing specialist visits?
- Have my preferred doctors or pharmacies changed, or have I moved to a new area?
- Do I expect any changes in my health status or chronic conditions that could affect my care?
Your health needs can shift from year to year, and your Medicare plan should shift with them. These questions help ensure you’re choosing coverage that fits your life now, not the one you had two years ago.
Don’t Skip Your Annual Review
Medicare’s open enrollment runs from October 15 to December 7, and this year’s review could be one of the most important yet. Even if your prescriptions haven’t changed, your drug plan may have changed. Reviewing your drug coverage with a Medicare specialist can help you:
- Confirm your drugs are still covered
- Compare premiums and pharmacy networks
- Prepare for 2026’s major updates
Independent agents like me enjoy working with you and helping you cut through all the noise of the Medicare system.
However, Recent changes in Medicare Advantage and Prescription Drug Plans have allowed insurance carriers to terminate contracts with licensed agents, cutting out the professionals who help seniors make informed decisions.
Without agents, you are left to navigate complicated plan options on your own or spend hours on hold with carriers — often without getting the guidance needed. As a community we are continuously working on your behalf to communicate with Congress about what needs to change in the Medicare industry.
We have found this is more powerful coming from your voice than ours. Your voice matters. You can help protect access to licensed Medicare agents by emailing your local Congressperson.
Make your voice heard:
If you’d like to let Congress know how valuable agent support is, go to www.house.gov, enter your ZIP code, and click the envelope icon to email your representative. You can copy this message:
Dear [Congressperson’s Name],
Cutting agents out of Medicare plans leaves seniors like me without trusted guidance. My agent has been essential in helping me understand my coverage and avoid costly mistakes. Please protect our access to the personal help we depend on.
If you ever have issues with your prescription plan in 2026, keep these steps handy to reach your representative again.
Take a few minutes now to review your Medicare plan. It could save you hundreds (or thousands) in the coming year.