I'm taking a brand-name medication that doesn't have a generic version. How can I find a Medicare Part D plan that will cover it at a reasonable cost?

Question

Jason Rubin · Accepted Answer

To find a Medicare Part D plan covering your brand-name medication, use the Medicare Plan Finder on Medicare.gov and input your medication, dosage, and preferred pharmacies to compare plans and costs.

Mark Maliwauki · Answer

You can go to Medicare.gov, type in your zip code to find the available plans in your county and then type in the Rx you are looking to source.

Misty Bolt · Answer

I can help you or Medicare.gov can tell you. I would use an agent because medicare. Gov is not 100% accurate.

David Bell · Answer

Most plans have a medication cost finder, so you can put the  name and dosage in and it will tell you what you'll need to pay. It will also tell you what Tier the medication is in for that company. The Tier determines if there is a deductible and what the co-pay is and is usually a number from 0-6. 

If it is name brand you will have a deductible between $0 and $590, for the first times it is filled. If it is a $100 medication and the deductible is $590, you will pay $100 for the first five months and $90 plus your co-payment in the sixth month. Co-payments are generally $45-100 or a % of the cost. So the seventh month, you may just pay $50 (the co-pay) and would be the same for the rest of the year. 

If it is an $800 medication, the first time you get it filled it will be the deductible plus your co-pay, so it may look really expensive the first time at $590 + $50 or more. The next month the deductible will satisfied and you will just pay the co-payment.  

If you take several name brands it is important to look for the plans that cover all of them, depending on what they are it can be a challenge. Reach out to an agent for help. They don't cost anything and most are happy to help look things up.

Michael Ryan · Answer

Work with an independant agent that has access to all the plans.. 

The changes in 2025 to Part D has caused every plan to review and adjust coverage. Not every plan covers every drug in their forumulary.  This was the area I spent the most time on this year for my clients to help them get the coverage needed...

Eli Roque · Answer

Both Medicare advantage plans and standalone Part D plan have a list of prescription drugs that they cover and cost which is the formulary !!

Steven Bleicher · Answer

Very tough situation here. I would first check with the drug mfr to see if their online site may have an available subsidy? Then, consider using either a US or Canadian discount website if the Part D plan shows an excessive copay. Moreover, Google foundations who offer reimbursements for a brand name drug.

Answered by Steven Bleicher on May 29, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Timothy Brown · Answer

Since prescription drug cost vary per carrier, the best way to find the lowest cost is to work with an agent for assistance or go directly to Medicare.gov

Diana Garner · Answer

The best answer is to speak with your agent/broker, who can help you.  Your agent/broker should create a list of your medications and dosages to research.  

If you do not choose to work with an agent or broker, you'll need to compare plans and their formularies, considering premiums, copays, and the network of pharmacies.
     1) Create a list of your medications and dosages.
     2) Go to www.medicare.gov
     3) Scroll down to "Find health & drug plans" and click on "Find Plans Now."
     4) Enter your zip code and click "Continue."
     5) Select "Medicare drug plan (Part D)" then click "Find Plans."
     6) Follow the prompts to select the options that apply to you.
     7) Add all your medications to the list, then click "Done Adding Drugs."
     8) Select your pharmacy preferences then click "Continue to View Plans." 
          NOTE: I always recommend searching with Mail Order and 4 local pharmacies selected 
          to get a better range of options.
     9) Now, compare the plans that are available for your area and choose one.

Diana Salisbury · Answer

Go to www.Medicare.gov and type in what  prescription your taking.  Then if not covered by one of the plans, your doctor might have to write an exception for your plan to help cover you.

Walt Smith · Answer

I will be happy to look it up for you. We look at every plan and Medicare has available and see what’s best for you.  That is which one has the lowest cost.  

In the unlikely event that Medicare does not cover your medicine, your doctor can always ask for an exception, and the Medicare plan may cover it.

Fred Manas · Answer

The prescription drug plans allow for completion amongst the carriers.  You can load your runs on medicare.gov and select Search PDP's.
You will be presented with all the options available in your area.   Compare  three insurers side by side to see who they are similar and how they are different.  Select the plan that fits your budget.

Steve Brauer · Answer

Your Independent Medicare agent that solely does Medicare should be able to strategize plans for you that cover your particular medication with the best coverage. Every carrier has their own "Formulary", which can differ greatly. If you have an expensive medication, you may have to spend a little more money each month to have it covered under a specific Part D plan.

Answered by Steve Brauer on April 8, 2025

Broker Licensed in AZ & CA

Answered by Steve Brauer Medicare Insurance Agent

Gary Henderson · Answer

Reasonable is relative. To find the best medical part D coverage give me a call. or you can DIY on healtcare.gov website. there are times of the year you can change plans typically Oct 15-Dec 7 for Jan 1 start. Unless you are new to medicare now.

Answered by Gary Henderson on May 24, 2025

Agent Licensed in TX, AK, AL & 46 other states

Answered by Gary Henderson Medicare Insurance Agent

Mike Henry · Answer

Go to Medicare . Gov and put in all your prescriptions in there. It will bring up plans that are available to you. Don’t just choose cheapest price. Look at overall out of pocket plus pric.

Mary Salmon · Answer

It is best to use a Medicare plan finder such as on the medicare.gov website. These tools can help you compare plans based on your particular prescription drugs so you can shop based on co-pay costs. You can also visit with a licensed Medicare agent to help with the process.

Answered by Mary Salmon on April 9, 2025

Broker Licensed in TX & OK

Answered by Mary Salmon Medicare Insurance Agent

Andre Cabral · Answer

Licensed agents can search the plans they represent to find the medication you need and inform you of the price at the same time.

Michael Turkaly · Answer

The agent can search your medication on the insurance companies formulary,which is a list of covered medications.

Mitchell Nunn · Answer

One option is to meet with a licensed agent that represents multiple plans. Another option is to visit Medicare.gov to confirm costs.

I'm taking a brand-name medication that doesn't have a generic version. How can I find a Medicare Part D plan that will cover it at a reasonable cost?

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I'm taking a brand-name medication that doesn't have a generic version. How can I find a Medicare Part D plan that will cover it at a reasonable cost?

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