What Is Medicare Part D and How Does It Work? A Complete 2025 Guide to Prescription Drug Coverage for Seniors

Dvir MoschePosted in Uncategorized last updated on April 9, 2025

What Is Medicare Part D and What Does It Cover? 💊

Medicare Part D is the part of Medicare that helps pay for prescription drugs.

This includes both generic and brand-name medications.

If you take medicine regularly—for high blood pressure, diabetes, or cholesterol—Part D can save you a lot of money.

Here’s the simple breakdown:

✅ Prescription Drug Coverage Basics

Medicare Part D helps pay for the medications your doctor prescribes.
It covers the drugs you pick up at the pharmacy.
It’s not automatic — you need to sign up for a plan.

🏢 Offered by Private Insurance Companies

Part D plans are run by private insurance companies, not the government.
But don’t worry — Medicare has to approve each plan, so they follow rules to protect you.

Real-life example: Let’s say you live in Florida and take 3 daily medications.

You can pick a Part D plan from a company like Aetna, Humana, or Wellcare that covers your area’s drugs at the lowest cost.

🧾 Covers Generic and Brand-Name Drugs

Generic drugs are lower-cost versions of brand-name drugs. Medicare Part D covers both.
Most plans give you a list (called a formulary) of drugs they cover.

📊 Tiers and Formularies Explained

Think of your plan’s formulary like a menu of covered drugs.
Drugs are placed into tiers:
- Tier 1 = lowest cost (usually generics)
- Tier 2 = medium cost
- Tier 3 and higher = higher cost (brand-name or specialty drugs)

💡 Tip: Always check the formulary before you choose a plan to make sure your prescriptions are covered at a good price.

How Medicare Part D Works 🧠💡

Understanding how Medicare Part D works can seem tricky, but let’s make it simple together.

Whether you have Original Medicare or a Medicare Advantage plan, you can still get help paying for your prescriptions.

🔄 How Part D Works with Medicare

If you have Original Medicare (Parts A & B), it does not cover prescriptions.
You’ll need to add a separate drug plan — this is called a Standalone Prescription Drug Plan (PDP).
If you have a Medicare Advantage plan (Part C), many already include drug coverage — called MAPD (Medicare Advantage Prescription Drug) plans.

✅ Example: Jane from Texas has Original Medicare.

She signs up for a Part D plan from Humana to help cover her blood pressure and arthritis meds.

Meanwhile, Mark from Ohio chose a Medicare Advantage plan with drug coverage built-in, so he didn’t need a separate Part D plan.

📘 The Four Medicare Part D Coverage Phases

Medicare Part D has four stages throughout the year.

The amount you pay depends on what phase you’re in.

1️⃣ Deductible Phase

You pay 100% of your drug costs until you meet your deductible.
In 2025, most plans have a deductible up to $590.
Some plans don’t apply the deductible to Tier 1 and Tier 2 drugs.

2️⃣ Initial Coverage Phase

After the deductible, you enter initial coverage.
You pay a copay or percentage for each drug.
The plan pays the rest.

💊 Example: You pay $5 for a generic drug, and the plan covers the rest.

3️⃣ Coverage Gap (Donut Hole) 🍩

Once you and your plan spend $5,030 combined on covered drugs (in 2025), you enter the coverage gap.
During this phase, you pay up to 25% of the cost for both generic and brand-name drugs.

🔍 Why is it called the “donut hole”?

Because there used to be a big hole in coverage — now it’s smaller, but still there.

4️⃣ Catastrophic Coverage Phase

Once your out-of-pocket costs hit $8,000 in 2025, you enter this final phase.
Here, you pay nothing for your drugs the rest of the year. 🎉

🗺️ Whether in California, New York, Arizona, or North Carolina, these same rules apply — but which Part D plan is best for you depends on your medications, pharmacy, and zip code.

What Drugs Are Covered Under Medicare Part D? 💊📋

Every Medicare Part D plan has a list of drugs it covers, called a formulary.

Knowing how formularies work can help you save money and avoid surprises at the pharmacy.

📄 Formularies Explained

Think of a formulary like a menu of approved medicines.

Not all drug plans cover the same drugs, so it’s important to check before you sign up.

Most formularies have tiers, or levels, that affect what you pay:

Tier 1 – 💰 Lowest cost: Common generic drugs
Tier 2 – Slightly higher cost: Some preferred brand-name drugs
Tier 3 – 💸 Higher cost: Non-preferred brand-name drugs
Tier 4/5 – 💲💲 Highest cost: Specialty or rare-use drugs

Preferred drugs usually cost less than non-preferred drugs in the same tier.

❓ What If Your Drug Isn’t Covered?

If your plan doesn’t cover your medication, don’t panic — you have options:

Talk to your doctor about a similar drug that is covered.
Ask the plan for an exception if your doctor says only that drug will work for you.
You can also switch to a plan that covers your drug during open enrollment (October 15 – December 7).

📍 Example: Martha in Illinois finds out her plan doesn’t cover her heart medicine.

Her doctor sends a letter to the plan, and they approve it through an exception request.

📝 Prior Authorization and Step Therapy

Some plans may ask you to go through a few extra steps before they cover certain drugs.

✅ Prior Authorization

Your doctor must get approval from the plan before it will cover a drug.
This is usually for expensive or risky medications.

🧗‍♂️ Step Therapy

You must try a lower-cost drug first.
If it doesn’t work, then the plan covers the more expensive one.

💡 Tip: If you know a drug you take requires prior authorization or step therapy, be sure to talk to your doctor early — it can save time and stress at the pharmacy!

Wherever you live—from Arizona to Pennsylvania, from Houston to Miami—these rules apply nationwide.

However, the drugs covered can vary by plan, so always check your specific plan’s list!

How Much Does Medicare Part D Cost in 2025? 💰

When it comes to Medicare Part D, there are several different costs to keep in mind.

Let’s walk through each one together, step by step.

💳 Monthly Premiums

A premium is what you pay each month just to have the plan — kind of like a subscription.

In 2025, the national average premium for Medicare Part D is around $34.50/month.
Some plans are as low as $0, depending on where you live and what help you qualify for.
Other plans can cost $100/month or more, especially if they cover lots of expensive drugs.

📍 Example: In California, you might find a plan for $10/month, while in Florida, the best option for your medications could be $35/month.

It all depends on your zip code and drug list.

🧾 Deductibles

A deductible is the amount you pay out of pocket before the plan starts helping.

In 2025, the maximum deductible allowed is $590.
Some plans have a $0 deductible for lower-cost drugs in Tier 1 or Tier 2.

💊 Copays and Coinsurance

Once you meet your deductible, you’ll still pay something each time you pick up a prescription.

A copay is a set dollar amount, like $3 for a generic.
Coinsurance is a percentage, like 25% of the drug’s cost.

🧓 Example: Betty in North Carolina pays a $10 copay for her cholesterol pills, but her brand-name inhaler has 25% coinsurance, which means she pays about $90 each time.

🛑 There’s No MOOP for Part D

MOOP stands for Maximum Out-of-Pocket — the limit on how much you pay in a year.

Original Medicare and Medicare Advantage plans have a MOOP.
But Medicare Part D does NOT have a MOOP.
However, in 2025, when your out-of-pocket drug costs hit $8,000, you reach the catastrophic phase, and your drug costs go down to $0 for the rest of the year. 🎉

💼 How IRMAA Affects Higher-Income Seniors

If you have a higher income, you may pay an extra monthly charge for Part D.

This is called IRMAA (Income-Related Monthly Adjustment Amount).

Here’s how it works in 2025:

Income (Single)	Income (Married)	Extra Monthly Charge
$103,000 or less	$206,000 or less	$0
$103,001–$129,000	$206,001–$258,000	+$12.90
$129,001–$161,000	$258,001–$322,000	+$33.30
$161,001–$193,000	$322,001–$386,000	+$53.80
$193,001–$500,000	$386,001–$750,000	+$74.20
Over $500,000	Over $750,000	+$81.00

🔍 You don’t pay this directly to the drug plan — it’s billed by Medicare, often taken from your Social Security check.

So whether you’re in Phoenix, Arizona or Albany, New York, Part D costs can vary — but now you know exactly what to expect and how it works.

Top Medicare Part D Insurance Providers in the U.S. 🇺🇸

There are many companies offering Medicare Part D plans, but a few big names stand out because of their nationwide coverage, high ratings, and strong reputations.

Let’s take a look at the top providers in 2025 and where they shine.

⭐ 2025 Star Ratings from Medicare (CMS)

Every year, Medicare (CMS) gives each drug plan a star rating from 1 to 5 stars:

⭐⭐⭐⭐⭐ = Excellent
⭐⭐⭐⭐ = Above Average
⭐⭐⭐ = Average
⭐⭐ = Below Average
⭐ = Poor

💡 The higher the stars, the better the plan performs in areas like customer service, safety, and drug pricing.

🏆 Top National Medicare Part D Providers in 2025

Here are some of the biggest and most trusted names in the country for Medicare drug plans:

✅ UnitedHealthcare (AARP)

Partnered with AARP, great for brand trust and national coverage.
Popular in states like Florida, Texas, California, and the Carolinas.
Offers plans with broad formularies and strong pharmacy networks.

✅ Humana

Known for competitive pricing and strong mail-order pharmacy options.
Big presence in the Southeast — Georgia, Alabama, South Carolina, and Kentucky.
Many plans rated 4 stars or higher in 2025.

✅ CVS Health / Aetna

Offers affordable plans and access to CVS Pharmacy locations.
Strong in Ohio, Pennsylvania, Arizona, and the Midwest.
2025 star ratings are generally 3.5 to 4 stars.

✅ Wellcare

Known for low premiums and broad drug coverage.
Big in states like New York, Texas, and California.
Often a go-to for folks with limited income or chronic medications.

✅ Cigna

Offers strong customer service and simple plans with no deductibles.
Big in Tennessee, North Carolina, Illinois, and parts of Texas.
Many plans earn 4-star ratings in 2025.

✅ Mutual of Omaha Rx

Trusted brand, especially among seniors.
Growing in popularity across the Great Plains and Mountain West — Nebraska, Colorado, Utah.
Known for excellent support and stability.

🌍 Which Companies Dominate Which States?

Depending on where you live, one or two companies may dominate the market:

Florida: UnitedHealthcare (AARP) and Humana are leaders.
California: Wellcare, UnitedHealthcare, and Aetna are strong options.
Texas: Humana, Cigna, and Wellcare are widely chosen.
New York: Wellcare and Aetna stand out.
North Carolina & South Carolina: UnitedHealthcare and Humana lead the way.
Arizona: CVS/Aetna and Cigna have solid coverage.

🧓 Tip for Seniors: Just because a company is big doesn’t mean it’s best for your prescriptions.

Always compare formularies, pharmacies, and star ratings in your zip code.

How to Compare Medicare Part D Plans 🔍📋

Looking at all the different Medicare Part D plans can feel like trying to read fine print with a magnifying glass!

🧐 But don’t worry — let’s break it down step by step so you can choose the right plan for your needs.

🖥️ Medicare.gov vs. Using an Independent Agent

There are two main ways to compare plans:

Option 1: Medicare.gov Plan Finder

You can visit Medicare.gov and use the Plan Finder Tool.
It lets you type in your medications and see which plans cover them.
But many seniors find it confusing and overwhelming — too many options, charts, and details.

💬 “I tried it but gave up — I wasn’t sure what I was even looking at.” – Ellen, age 72 from Ohio

Option 2: Talk to an Independent Agent

A licensed agent can help you compare plans side by side.
They’ll look at your prescriptions, your pharmacy, and your budget.
They can explain things in plain English and even help you enroll.

👂 Bonus: Agents know which plans work best in your area, like Aetna in Arizona or Humana in Georgia.

💊 What to Compare When Choosing a Part D Plan

Whether you’re doing it yourself or working with an agent, here’s what really matters:

Formulary – Does the plan cover your medications? What tier are they in?
Pharmacy Network – Is your favorite pharmacy in-network?
Costs – What’s the monthly premium, deductible, and copay for your drugs?

🧓 Example: Jack in North Carolina takes 4 medications.

One plan charges $12/month with a $500 deductible, while another is $22/month but covers his meds with no deductible.

The second plan saves him money in the long run.

🧰 Plan Finder Tool: Helpful But Confusing

The Plan Finder Tool on Medicare.gov is helpful — but only if you know what you’re doing.

It compares drug costs, pharmacies, and coverage phases.
But it doesn’t explain what to look for, and you might miss important details.
That’s why many seniors prefer a local agent or trusted advisor to walk them through it.

🧠 Tip: If you feel stuck or unsure, don’t go it alone. Get help — it can save you money and stress.

How to Enroll in Medicare Part D 📝💊

You can’t get prescription help unless you enroll in a Medicare Part D plan.

But don’t worry — there are specific times each year when you can sign up or make changes.

Let’s review the main enrollment periods and what happens if you wait too long.

🗓️ Initial Enrollment Period (IEP)

This is your first chance to sign up.

Your Initial Enrollment Period starts 3 months before you turn 65, includes your birthday month, and lasts 3 months after.
That gives you 7 full months to sign up for a drug plan.

🎂 Example: Susan turns 65 in July. Her IEP runs from April 1 to October 31.

If you’re already receiving Social Security, you may be enrolled automatically in Parts A and B, but you’ll need to choose a Part D plan yourself (unless you pick a Medicare Advantage plan that includes drug coverage).

🔁 Annual Enrollment Period (AEP)

This is your once-a-year chance to change plans — even if you already have one.

AEP runs from October 15 to December 7 each year.
You can:
- Switch from one Part D plan to another
- Drop your current plan
- Move from a Medicare Advantage plan back to Original Medicare (and get a new Part D plan)

📍 AEP is the most popular time to review your current drug list and compare options.

🚨 Special Enrollment Periods (SEP)

Sometimes, life changes give you a chance to enroll or switch plans outside the regular windows.

These are called Special Enrollment Periods.

You may qualify for an SEP if you:

Move to a new area that has different plans
Lose other drug coverage (like employer or VA benefits)
Get Extra Help (a program that helps with drug costs)
Live in or leave a nursing home or assisted living

🧓 Example: Henry moves from California to Florida in March.

He gets a Special Enrollment Period to choose a new local plan.

⚠️ Penalties for Not Enrolling When First Eligible

If you don’t sign up for Medicare Part D when you’re first eligible and don’t have other creditable drug coverage, you may pay a late enrollment penalty.

The penalty is 1% of the national average premium for every month you waited.
You’ll pay this penalty every month for life — added to your regular premium.

🧮 Example: If you wait 15 months, your penalty could be about $5.20/month — forever.

💡 Tip: Even if you don’t take any medications now, it’s smart to enroll in a low-cost plan to avoid future penalties.

Whether you’re in Michigan, Florida, Arizona, or North Carolina, these rules apply nationwide — but getting help from a licensed agent can make the process much easier.

What Is the Medicare Part D Late Enrollment Penalty? ⚠️💸

Many seniors are surprised to find out that waiting to sign up for Medicare Part D can cost them — every month for the rest of their life.

This is called the Late Enrollment Penalty, and once it kicks in, it doesn’t go away.

Let’s break it down in simple terms. 👇

📏 How the Late Enrollment Penalty Is Calculated

The penalty is based on how long you waited to sign up for Part D after you were first eligible — and didn’t have other drug coverage that Medicare considers “creditable” (like from an employer or the VA).

Here’s how it works in 2025:

The penalty is 1% of the national base premium for each month you went without coverage.
The national base premium in 2025 is $34.50.
That 1% penalty is added to your monthly Part D premium — forever.

💡 It adds up faster than you’d think.

🧓 Real-Life Examples

🔹 Example 1: Tom waited 10 months to enroll

1% x 10 months = 10% penalty
10% of $34.50 = $3.45/month
Tom pays an extra $3.45 every month for life

🔹 Example 2: Mary waited 24 months to enroll

1% x 24 months = 24% penalty
24% of $34.50 = $8.28/month
Mary pays $8.28 extra every month — forever

😕 Why So Many Seniors Accidentally Trigger It

A lot of folks make this mistake because:

They don’t take any medications, so they think they don’t need a plan yet.
They think Original Medicare covers prescriptions (it doesn’t).
They don’t know that even a short delay can cause a lifelong penalty.

🚫 Just skipping one year without coverage can cost you hundreds of dollars over time.

✅ How to Avoid the Late Enrollment Penalty

The good news?

It’s easy to avoid:

Sign up for a Medicare Part D plan as soon as you’re first eligible.
Even if you don’t take any meds, choose a low-cost plan (some are under $10/month).
If you have other drug coverage (like from a job or the VA), make sure it’s creditable and keep proof.

🧾 Always ask your plan or HR department: “Is this considered creditable drug coverage by Medicare?” Get it in writing if you can.

This penalty is one of the most common surprises seniors face — but now you know how to avoid it!

Whether you’re in Texas, Ohio, Pennsylvania, or Oregon, the rules are the same.

Best Medicare Part D Plans for Specific Needs 🎯

Not all Medicare Part D plans are the same.

Some work better for people with tight budgets, some for those with chronic conditions, and others are great for home delivery.

Let’s look at the best options based on your personal needs.

💸 Best for Low-Income Seniors

If you have a limited income, you may qualify for Extra Help, also called LIS (Low-Income Subsidy).

Extra Help can lower your premiums, deductibles, and drug costs — sometimes down to $0!
Many plans are specially designed for people who qualify.

📌 Top picks for Extra Help plans in 2025:

Wellcare Classic
SilverScript SmartSaver (by Aetna)
Humana Basic Rx

💬 Example: Gloria from Georgia qualified for Extra Help.

She now pays $0 for her Part D plan and just a few dollars for her medications. 😊

💉 Best Plans for Diabetes Medications

If you take insulin or other diabetes drugs, some plans offer special low copays through Medicare’s Senior Savings Model.

📌 Top plans for diabetes meds in 2025:

Humana Walmart Value Rx Plan – Known for $35 or less insulin
SilverScript Choice – Covers many diabetes meds at affordable copays
UnitedHealthcare (AARP) Medicare Rx Walgreens – Great if you prefer Walgreens as your pharmacy

🧓 Tip: Always check that your exact insulin brand and dose are covered!

📦 Best Plans for Mail-Order Convenience

If you prefer your prescriptions delivered right to your door, some plans have excellent mail-order services that can save time and money.

📌 Top plans for mail-order in 2025:

Humana – Offers deep discounts with mail delivery from CenterWell Pharmacy
Cigna – Great mail-order reliability with fast shipping
SilverScript (Aetna) – Easy-to-use mail-order program and low prices on generics

✉️ Example: Joe in Arizona switched to a mail-order plan and now gets a 90-day supply delivered, saving him three trips to the pharmacy each season!

🏆 Best National Medicare Part D Plans (2025)

These plans are widely available and offer strong coverage, good customer service, and competitive pricing:

SilverScript (Aetna) – Backed by CVS, popular for low premiums
Humana – Affordable options, broad drug coverage
Wellcare – Great for low-income seniors and value pricing
UnitedHealthcare (AARP) – Trusted name with nationwide options
Cigna – Reliable service and strong pharmacy partnerships

📍 These plans are top choices in states like Florida, Texas, California, and North Carolina.

Whether you’re looking for the cheapest option, help with chronic conditions, or the easiest way to get meds at home, there’s a Medicare Part D plan that can fit your life. 💊❤️

How the Extra Help (LIS) Program Works 💰💊

If you’re on a tight budget, Medicare has a special program to help you pay for your Part D drug plan.

It’s called Extra Help, and it can save you thousands of dollars each year — and many seniors don’t even know they qualify!

✅ What Is Extra Help?

Extra Help (also called LIS) is a federal program that helps pay for:

Your monthly premium
Your deductible
Your copays for prescriptions

In some cases, it even makes your drug plan free. 🙌

📋 Who Can Get Extra Help?

To qualify, your income and savings must be below a certain amount.

In 2025, you may qualify if:

Your income is below $22,590 (individual) or $30,660 (married couple) per year
Your resources (savings, stocks, etc.) are below $17,220 (individual) or $34,360 (couple)

🧓 Example: Maria from North Carolina gets Social Security and a small pension.

She qualified for Extra Help and now pays $0 for her Part D plan and only $4.50 for her prescriptions!

📝 How to Apply for Extra Help

You can apply online, by phone, or by paper form:

Online: Visit ssa.gov/extrahelp
Phone: Call Social Security at 1-800-772-1213
In person: Visit your local Social Security office

You can also get help applying through a licensed agent or local senior resource center.

💬 Tip: If you already have Medicaid, SSI, or live in a nursing home, you may be automatically enrolled in Extra Help!

🛡️ It Also Protects You from the Late Enrollment Penalty

Here’s a big bonus:
If you qualify for Extra Help, you don’t have to pay the Part D late enrollment penalty — even if you waited years to sign up.

⚠️ Example: George from Texas didn’t sign up for Part D at age 65 and was facing a penalty.

But after getting Extra Help, his penalty disappeared!

Extra Help is a game-changer. If you think you might qualify, it’s absolutely worth applying.

Whether you live in Ohio, Florida, California, or the Carolinas, this benefit is available nationwide and can make a big difference. 💊❤️

How Medicare Part D Is Changing in 2025 🔄📅

Big improvements are coming to Medicare Part D in 2025 — and they’re all about saving you money.

Thanks to the Inflation Reduction Act, seniors will see lower out-of-pocket costs, especially for insulin, vaccines, and expensive prescriptions.

Let’s look at what’s changing — and why it matters. 👇

🛑 New $2,000 Out-of-Pocket Cap (MOOP)

Starting in 2025, Medicare Part D will have a Maximum Out-of-Pocket limit (MOOP) of $2,000 per year.

This means once you’ve spent $2,000 on covered prescriptions in a year, you won’t pay anything else for the rest of the year.
This is huge for seniors with high-cost medications like cancer drugs, inhalers, or specialty meds.

🧓 Example: Janet from Pennsylvania was spending over $4,000 a year on arthritis medications.

In 2025, she’ll be able to cut that in half — saving thousands! 💵

💉 $0 Cost for Recommended Vaccines

In 2025, vaccines recommended by the CDC (like shingles, pneumonia, and flu shots) will continue to be free under Medicare Part D.

No copay
No deductible
No surprise bills

💡 That’s great news for seniors who want to stay healthy and avoid unexpected pharmacy costs!

💙 $35 Insulin Cap Continues

Medicare’s insulin savings program is still going strong:

You’ll pay no more than $35/month for each covered insulin.
This applies whether you get insulin through Part D or a Medicare Advantage plan with drug coverage.
Some plans even offer certain insulin brands for $0 out of pocket!

🩸 Example: Bill in Arizona uses two types of insulin. In 2024, he was paying $70/month total — in 2025, it’s still capped at $70 max, possibly less.

🧠 Real Implications for Seniors

Here’s what all this really means for you:

If you take expensive medications, you’ll now have predictable yearly costs.
You’re protected from sky-high pharmacy bills that used to come after hitting the “donut hole.”
You can finally plan your healthcare budget with confidence. 💪

📍 No matter where you live — from Florida to Oregon, New York to North Carolina — these Medicare Part D changes apply to every senior in the U.S.

These changes make Medicare Part D stronger, fairer, and more affordable for seniors everywhere.

If you’ve ever skipped a medication because it cost too much, 2025 is your year to get the care you need without the stress. ❤️

America’s Top Hospitals and Pharmacies for Part D Users 🏪🏥

Choosing the right Medicare Part D plan is about more than just drug coverage — it’s also about where you go to pick up your prescriptions and get care.

Let’s take a look at the top pharmacies and hospital systems trusted by seniors, and why using a preferred pharmacy could save you big! 💵

🏪 Major National Pharmacy Chains

Many Medicare Part D plans have a “preferred pharmacy network” — meaning if you go to certain stores, you’ll pay less out of pocket.

Here are the top 3 pharmacy chains used by most seniors with Part D:

✅ CVS Pharmacy

Often preferred for Aetna and SilverScript plans
Great for in-person and mail-order options
Over 9,000 locations nationwide

✅ Walgreens

Popular with UnitedHealthcare (AARP) Part D plans
Offers convenient refills, vaccines, and extended hours
Locations in almost every state

✅ Walmart & Sam’s Club

Used by Humana Walmart Value Rx plans
Known for low prices on generic medications
Over 4,500 locations across the U.S.

🧓 Example: Alice in Tennessee switched her Humana plan’s pharmacy from a local store to Walmart — and cut her medication cost by 50%!

🏥 Top Hospital Systems with In-Network MAPD + Part D Coverage

If you have a Medicare Advantage plan with drug coverage (MAPD), your doctors and hospitals must be in-network for full coverage.

Some of America’s best hospital systems are in-network with major MAPD and Part D carriers:

🏥 Mayo Clinic

Located in Minnesota, Arizona, and Florida
Works with select MAPD plans that include prescription drug coverage
World-famous for specialty care

🏥 Cleveland Clinic

Based in Ohio, with growing locations in Florida and Nevada
Often in-network for UnitedHealthcare and Aetna Medicare Advantage plans

🏥 Johns Hopkins Medicine

Based in Maryland, one of the top hospitals in the U.S.
Offers its own Medicare Advantage plans, and works with other national carriers

💡 Tip: Always check that your hospital and pharmacy are in-network before enrolling in a plan — it can mean big savings and smoother care.

💳 Why Preferred Pharmacies Matter

Going to a preferred pharmacy can:

Lower your copays
Give you access to 90-day supplies
Help you qualify for extra discounts or even $0 copays on certain drugs

📌 Not all pharmacies are treated the same, even inside the same plan. Using the wrong one could double your cost.

📍 Example: Bob in North Carolina takes two medications.

At his regular pharmacy, he was paying $60/month.

By switching to a preferred pharmacy, it dropped to $18/month!

Whether you live near a CVS in New York, a Walmart in Texas, or visit the Mayo Clinic in Florida, understanding your pharmacy and provider network is a big part of getting the most out of your Medicare Part D plan. 🧾💊

How Palmetto Mutual Helps You Pick the Right Part D Plan 🧑‍⚕️📞

At Palmetto Mutual, we make Medicare simple, stress-free, and personal — just the way it should be.

Whether you’re new to Medicare or just tired of trying to figure it all out alone, we’re here to help you find a Part D plan that fits your life and your budget.

🚫 No Robocalls. No Spam. No Guessing.

You’ve probably had enough of the endless phone calls, junk mail, and confusing websites.

We don’t do any of that.

No pressure.
No gimmicks.
Just real help from real people who care.

📍 Local, Licensed Experts Who Listen

We live and work right here in the Carolinas — and we know the plans available in your area, not just what shows up online.

We compare all your options, side-by-side
We help you find plans that cover your medications at your favorite pharmacy
We take the time to explain everything in plain English

💬 “They talked to me like a real person and made it so easy.” – Doris, 72, Florence, SC

💸 Need Help Paying for Your Medications? We’ve Got You.

If you might qualify for Extra Help (LIS), we’ll walk you through it:

We’ll explain the program
Help you apply
And follow up to make sure it goes through

You won’t have to figure it out alone — we’re here every step of the way.

😌 We Explain the Confusing Stuff So You Don’t Have to Stress

What’s a formulary? What’s the donut hole?

What does coinsurance mean?

We’ve got all that covered — and we actually enjoy helping you understand it.

When you work with Palmetto Mutual, you’ll walk away feeling:

Informed (not overwhelmed)
Confident (not confused)
Relieved (not frustrated)

📞 Let’s Make Medicare Easier — Together

If you’re in South Carolina or North Carolina, or helping a loved one who is, give us a call.

At Palmetto Mutual, we’ll treat you like family, not a number.

👉 Want help comparing plans or applying for Extra Help?

We’re just one call away.

Conclusion: Your Medicare Drug Coverage Shouldn’t Be a Mystery 🧩💊

You deserve better than confusing websites, endless hold music, or pushy salespeople.

Medicare Part D doesn’t have to be overwhelming — not when you’ve got the right team on your side.

At Palmetto Mutual, we believe in:

Clarity over confusion
Real conversations over robocalls
Support that’s local, personal, and pressure-free

Whether you take one medication or ten, whether you’re brand-new to Medicare or just trying to fix a bad plan — we’ll help you get it right.

👉 Want real help picking a Medicare Part D plan that fits your life?

We’re ready when you are.