You may not be taking prescription drugs when you sign up for Medicare at age 65, or when your work coverage ends. But it is a sure thing that as you age you will eventually be taking some drugs – for blood pressure or cholesterol control, or for more serious ailments. Count on it – and count that it will be expensive.

That’s why, immediately upon signing up for Medicare Part B, you must also sign up for Part D – drug coverage – even though you are currently taking nothing stronger than Tylenol and a daily vitamin. Technically, signup for Part D isn’t required – but you’ll pay a significant extra amount as a monthly premium penalty if you sign up later, when you really need the coverage and the caps on spending that Part D offers.

Even more important — you must REVIEW your Part D drug coverage every single year during the October 15 – December 7th Open Enrollment period. Even if you are taking the same drugs. Even if you want to use the same pharmacy. Even if you liked your plan this year. You MUST review your coverage – and be prepared to switch.

That’s because the plans change their pricing and the drugs they cover (their formularies) – every year! What was a good deal for 2025, might be an expensive plan for 2026. And if you fail to do a review, you will be defaulted into last year’s plan – and could face an expensive surprise.

I hope I have your attention. This column is designed to make reviewing your Medicare Part D plan easy. But it’s never going to be really easy – unless you get inexpensive and trusted help. I’ve put that easy solution at the end of the column.

But first some key critical things you must know to get started:
1. Starting in 2026, insurance companies do not pay commissions to insurance agents for signing people up for Part D drug plans. (Last year, 2025, the commission was about $57 per plan signup.) So no one – with the one exception below—is going to hold your hand through the process of finding the best drug plan. It just doesn’t pay any more.

2. The good news is that in 2026, you will spend no more than $2100 out-of-pocket for ALL of your covered drug expenses and deductible, not including monthly premiums (if any). The BAD news is that not all of your prescribed drugs may be covered! If your drug isn’t covered, and your physician can’t find a generic substitute, then you are on the hook to pay in full.

3. When searching for a new Part D drug plan for 2026, you must first update your drug list. (See below for the easy way to do that) BUT if you are prescribed a new drug during the coming year, there is no guarantee it will be covered by the plan that you are signing up for right now for 2026!

4. If you are part of a Medicare Advantage plan that covers your drugs, you might also want to check about the total costs of co-payments if any, and to be certain the plan formulary includes your drugs Since you can also switch Advantage Plans during open enrollment, the coverage – or lack of coverage – for your prescriptions might make you decide to change plans, assuming your physicians are in the new plan.

Getting Started Choosing a Plan
Unless this is your first year with a Part D drug plan, you should have created an account at Medicare.gov. It’s easy to do if you are a newcomer. But if you already have an account sign in by clicking the “log-in” button on the top right corner of your screen.

Once you’re logged in you’ll see your name appear at the top right corner. Click on that to see your “Medicare Account.” Then immediately click on “My Saved Drugs”.

You’ll find the drugs that were included in your plan last year. But what if you stopped taking a drug, or added a new one? Click on “Add Another Drug.” You’ll be amazed to see a list of all your prescriptions that were filled during the past year. If you took an antibiotic for 10 days, you don’t want to add that to your annual list. But any new prescription can easily be added to your drug list. You can also easily delete old prescriptions you are no longer using.

It is critical that your prescription drug list be current and correct in terms of dosages before you start a search for your 2026 plan.

While you’re at it, double check your list of “preferred pharmacies” – those that are close to your home or ones that provide mail order delivery.

Once your drug list is up to date, scroll to the bottom of that page to “Start A New Plan Search.” That leads to a page that shows your current 2025 plan if you have one. So look for the pop-up box: “Start a New Search for a 2026 Plan”. After reconfirming your zipcode, you’ll see your choices for 2026 – listed in order of total out-of pocket costs.

That’s the critical number: Total Drug & Premium Cost for 2026. That’s how you choose – based on your total cost, not on the monthly premium. Some plans could have a zero monthly premium, but a higher cost of drugs. And not based on the deductible, which for 2026 can be no higher than $615. Some plans may have a lower deductible, but a higher total cost of your prescriptions!

For each plan, scroll down to Look for the link that says “View Drugs and Their Costs.” You’ll see what each costs – some have zero cost for generic blood pressure meds, for example – and some may have much higher costs, or may not be covered in this plan. It’s critical to review this display of drug costs.

If you have expensive drugs, you may find that you’re paying a lot in the first few months of the year, until you meet the cap limitation. After that, your monthly cost will drop to zero. Some pharmacies participate in the payment plan to level the monthly costs, while others totally ignore this possibility.

Bottom Line: You should chose based on the total cost of your drugs for the year ahead – for the drugs that you’re including in your search. Again, all bets are off if you are prescribed a new, more expensive drug mid-year. It may be covered, or not.

Getting Help
There is one source of help with choosing a Part D drug plan. It’s a website called www.HEYMOE.com. (That stands for “hey – Medicare Open Enrollment.) Much like the Medicare.gov website, you enter your prescription drugs.

It will not only do the search for the lowest cost plan, but if a drug is uncovered or expensive, HeyMOE will automatically check for a GoodRx coupon and show it if one is available. No extra effort required.
If the system detects a particularly complex case (such as a drug that’s not covered or has no clear lower-cost alternative) it flags the account for hands-on review by an individual expert who will look into whether there’s a biosimilar, a different formulation, or even a manufacturer assistance program that might help.

The yearly fee for HeyMoe is $30. Following their independent recommendations means you are getting the best, least-cost plan for your prescriptions – with all options considered. And next year, they’ll automatically advise you on your best deal for your then-current prescriptions.

Don’t Procrastinate – Get Help
Every year seniors just decide they cannot afford to take their prescribed medicines. Or they pay too much for coverage under Part D. The annual cap of $2100 helps – but can still overwhelm a senior living on Social Security.

If you know a senior struggling with technology, or struggling with prescriptions, please lead them to HEYMOE.com or to SHIPHelp.org.

You have until December 7 to sign up for a Part D drug plan for 2026. It’s simple if you’re taking only a few generics. It gets more complicated the more drugs you take – especially if they are not covered by your plan, or can be obtained less expensively through special programs.

You can’t just guess at this year’s best plan to cover your potentially huge drug expense. You MUST do the work. Now. And that’s The Savage Truth.

[Note: the above is a longer version of my syndicated column that appears in newspapers around the country and is limited to far fewer words. In the above, I have tried to take you by the hand and walk you through the Part D process, which necessarily must be done online. PLEASE — share this link, print it out, post it at senior centers, help someone who isn’t a techie. Choosing the right Part D plan now is SO important!]