What Does Medicare Part D Cover in 2026?

If you’re on Medicare, you’ve probably asked yourself: Will my prescriptions still be covered next year? How much will I pay at the pharmacy? Let’s cut through the jargon and get right to it.

Medicare Part D is the part of Medicare that covers retail prescription drugs — the ones you pick up at the pharmacy counter or get through the mail. Think blood pressure pills, cholesterol meds, or insulin. For other key changes coming soon, see Medicare changes for 2026.

The Basics: What’s Covered?

• Most retail prescriptions → filled at the pharmacy
• Mail-order prescriptions → many plans give you a discount if you use this
• Generic and brand-name drugs → but the list (called a “formulary”) varies by plan

Here’s what’s not included under Part D:

• Drugs given during a hospital stay (that’s Part A)
• Drugs administered in a doctor’s office or outpatient clinic (that’s Part B)

So if you’re taking chemo, dialysis meds, or injections at the clinic, that usually falls under Parts A or B, not Part D.

How Do These Plans Work?

• You buy a stand-alone Part D plan (sometimes called a PDP) if you’re on Original Medicare.
• Or, you might get Part D “built-in” if you have a Medicare Advantage plan (those are called MAPDs). Learn more about Medicare Advantage changes.
• Premiums vary — some as low as $8 a month, others over $100. Most people pay somewhere in the $20–$30 range.

The Catch: Formularies

Every Part D plan has its own drug list (formulary). Just because one plan covers your prescription doesn’t mean another will. Formularies are divided into “tiers” — generics at the lowest cost, specialty drugs at the highest.

That’s why it’s not enough to just “have Part D.” You need the right Part D plan for your meds. To avoid common pitfalls, review Medicare mistakes to avoid.

Do You Need Part D?

If you:

• Take prescription drugs regularly,
• Don’t want to pay out-of-pocket at the pharmacy, or
• Plan to buy a Medigap (Medicare Supplement) plan alongside Original Medicare,

…then yes, you’ll need to pick a stand-alone Part D plan.

And don’t skip it thinking you’ll sign up later — Medicare penalizes you if you go too long without creditable drug coverage. See more on 2026 service area reductions and how they may affect your options.

The Bottom Line

Medicare Part D is your pharmacy benefit card. It helps pay for the prescriptions you take every day. What it covers — and what you’ll pay — depends entirely on the plan you choose.

If you’re heading into 2026, expect some plan changes and premium shifts, but the basics remain the same: Part D is there to cover the prescriptions you pick up at your local pharmacy.