Medicare Part D - Prescription Drug Coverage
Understand Medicare Drug Plans & Get Help Choosing the Right One
Medicare Part D plans provide prescription drug coverage for those enrolled in Medicare. Whether you take regular medications or just want peace of mind, having a drug plan in place can help you avoid surprise costs-and costly penalties. At The HgO Group, we walk you through your Medicare Part D options, help you compare plans, and make sure you're not paying more than you have to for the prescriptions you rely on.
We're here to help you understand what Medicare drug insurance covers, what it costs, and how to make the most of it.
Simple Prescription Coverage
What Is Medicare Part D?
Medicare Part D is prescription drug coverage available through private insurance companies. It comes in two forms:
- Standalone Drug Plans (PDPs) for those enrolled in Original Medicare

- Medicare Advantage Plans (MAPDs) that include drug coverage as part of an all-in-one plan
If you're enrolled in Original Medicare and want help paying for prescriptions, you'll likely need to enroll in a standalone Part D plan. Even if you don't take medication now, enrolling when first eligible is important to avoid future penalties.
if you're considering a plan that bundles drug coverage
What Do Part D Plans Cover?
Every Medicare drug plan has a formulary-a list of covered medications divided into tiers (usually from generics to brand-name or specialty drugs). While all plans must meet basic Medicare standards, formularies and pharmacy networks vary.
We help you:
Review which plans cover your medications
Check if your preferred pharmacy is in-network
Understand costs at each tier (co-pays, coinsurance, etc.)
Plans are required to cover drugs in most therapeutic categories, but not all plans cover every medication. That's why a personalized review is essential.
Part D Costs:
Premiums, Deductibles & the New $2,000 Cap
Medicare drug plans come with several cost factors:
- Monthly premium:
Varies by plan (low-cost options are often available)
- Annual deductible:
Many plans have a deductible (around $500), though some waive it for generic drugs
- Co-pays and coinsurance:
You pay a portion for each prescription, depending on the tier
Starting in 2025, there's a major improvement:
Once you've paid $2,000 out-of-pocket for your covered medications in a year, you'll pay nothing more for the rest of that year.
This replaces the confusing "donut hole" and puts a clear cap on annual drug expenses.
High-income individuals may also pay an IRMAA surcharge on top of the regular premium.
to learn more about income-based premium adjustments.
Avoid Penalties, Stay Covered
Do I Need a Part D Plan? What If I Skip It?
If you delay enrolling in a Medicare Part D plan and don't have other creditable drug coverage (like through an employer), you'll likely face a late enrollment penalty added to your monthly premium-for life.
Even if you aren't taking prescriptions today, having a low-cost Part D plan ensures you're protected from future penalties and unexpected drug costs. Not sure if your current coverage qualifies? We'll help you find out.
How We Help You Choose the Right Drug Plan
The best Medicare Part D plan isn't the one your neighbor chose-it's the one that covers your medications at the lowest cost.
At The HgO Group, we offer:
- Free Part D plan reviews based on your prescription list
- Guidance on pharmacies, plan tiers, and mail-order options
- Yearly comparisons during Open Enrollment
If you have a long list of prescriptions-or none at all-we'll tailor our recommendations to make sure your needs are met without overspending.
Get a Free Prescription Drug Plan Review
Unsure which Medicare Part D plan is right for you? We're here to make the process simple and stress-free. Whether you're enrolling for the first time or reviewing your coverage during Open Enrollment, The HgO Group can help you compare Medicare RX plans that meet your needs and fit your budget.
Contact us today for a personalized Part D review or