How do I know if my prescriptions will cost more next year?

Question

Lynn C Shurtleff · Accepted Answer

Most part D plans no longer have agents so your best bet is to go to Medicare.gov or call 1800 medicare. If a Medicare advantage client, call your agent or find a good, honest, local agent to work with.

Answered by Lynn C Shurtleff on October 13, 2025

Broker Licensed in TN, AR, CO & 6 other states

Answered by Lynn C Shurtleff Medicare Insurance Agent

Ronnie Robinson Jr · Answer

The easiest way we have found is to add in your current prescriptions, for example. We will then be able to show you the estimated cost with the available carriers in your area.

Jennifer McDonnell · Answer

Most likely they will until you hit the  catastrophic level.  Find a good independente insurance broker to assist each and every year.

Phillip Davis · Answer

Most plans adjust their formularies annually. This means that sometimes it's necessary to review and possibly change your coverage from year to year. To determine what your rx prices will be next year and what plans have the best benefits for you, it helps to reach out to a local agent and discuss everything.

Answered by Phillip Davis on October 20, 2025

Broker Licensed in WV, AZ, FL & 5 other states

Answered by Phillip Davis Medicare Insurance Agent

Dino Pappadis · Answer

That information is not available until October of every year when the Annual Election Period begins

Doreen Dann RN, BSN, MHA · Answer

Work with an independent licensed insurance agent credentialed with multiple carriers so they can help you find the most optimal prescription drug plans for the coming year

Jay Carlton · Answer

There are a few ways to look at them, one is talking with your agent and having them going over them with you. You can also go over to the Medicare website and plug them all in to see what plans and what costs they will be. Each plan will have a Teir level them them and the cost of what the copay or coinsurance will be for you.

Answered by Jay Carlton on October 27, 2025

Agent Licensed in UT

Answered by Jay Carlton Medicare Insurance Agent

Lydia Perez · Answer

Every year, around September your plan will send out a letter known as the Annual Notice of change that details any changes to your plan's premium, copays and changes to your formulary for the upcoming year. 

It's very important that you review this information prior to December 7th so make sure you there are no surprises for 2026.

Kristen Skinner · Answer

You can go to medicare.gov and plug them in to see the costs. And you can also enroll in a plan on the website. If you need more help, you can contact me. Kristen Skinner.

DeeDee Whitlock · Answer

Your agent who sold you your Medicare Supplement should review your plan EVERY year!You can also call 1-800-Medicare for them to check it out for you

Chad Watkins · Answer

How do prescription drug plans work? Most carriers are going to break down their prescription drugs into different tiers. It's very typical. There will be five tiers, with preferred generic drugs being tier one. That's going to be the least expensive. So you have tier one and tier two, which are generic, broken down into preferred and non-preferred. Tier three and four are brand name, broken down into preferred and non-preferred. And then tier five is for specialty drugs.

As you go up into tiers, you're going to pay more on the copay for that prescription. There is a deductible maximum. This has been set at $590 for 2025. It will be going up to $615 for 2026. And that is the maximum amount of deductible that a plan can charge. But they might make it less or even zero, depending on the plan.

So then you will pay the copays based on the tiers until you've reached the true out-of-pocket, known as true OOP. For 2025, it's $2,000, going up to $2,100 in 2026. So actually, after you've paid that actual amount out of pocket, then you will pay zero for your prescriptions.

There are a few programs you can look into that might help you pay for those prescriptions. There's the pharmaceutical assistance for the aged and disabled, and hearing aid assistance for the aged and disabled.

Shannan Pruitt · Answer

You will not know the cost of medication for 2027 until new plans are released in October. The prescription deductible, copay, coinsurance, max out of pocket and tier level structures can change from plan year to plan year. Make certain that you have your medications evaluated every year to make certain you are on the absolute best fit for your specific medication list. If you are on Medicare you can compare plans October 15th-December 7th of every year. This is your annual enrollment period. Your new drug plan will not take effect until the following January 1st.

Answered by Shannan Pruitt on March 23, 2026

Broker Licensed in AR, MO, OK & TX

Answered by Shannan Pruitt Medicare Insurance Agent

Karen Colbert · Answer

Plans are updated on year to year basis. You should receive an Annual Notice of change regarding changes that are being made for the next year. This information is usually mailed in September of each plan year.

Answered by Karen Colbert on March 30, 2026

Broker Licensed in TX

Answered by Karen Colbert Medicare Insurance Agent

Marie Goldbeck-Strunk · Answer

To know if your prescriptions will cost more next year, You should review the Annual Notice of Change (ANOC) letter sent by your insurance plan. These are sent out in September/October, you should also check the plan's updated formulary for tier changes, and if you do not have an agent/ broker you could use the Medicare Plan Finder to compare 2026 costs/ 2027 cost.

Answered by Marie Goldbeck-Strunk on May 6, 2026

Broker Licensed in IA, AZ, DE & 13 other states

Answered by Marie Goldbeck-Strunk Medicare Insurance Agent

Andrew Kramer · Answer

In order to find out, you need to, #1 download the 2026 Part D plan you have, or the Advantage plan, and find the place that shows the co-pays according to the Rx Tiers, typically 1, 2, 3, 4 and 5 (sometimes there's a Tier 6); then #2, you need to download the Rx formulary of that plan, then search your Rx names and note the tiers of each. There might also be an RX deductible, typically for Tiers 3-5, or only 4-5, or none, depending on the Part D plan. Now you can calculate your Rx costs. You can also call your agent and have him/her do that for you! You do have an agent, right? :)

Answered by Andrew Kramer on December 12, 2025

Agent Licensed in FL

Answered by Andrew Kramer Medicare Insurance Agent

Carol Thompson · Answer

Your agent ( if you have one)  can look up your medications or you can call members services to attain that information.

Rich Baker · Answer

There’s no crystal ball for medication pricing, but after the implementation of the Inflation Reduction Act, the trend has been for more providers to move their tier 3 (Brand Name) medications to a percent co-insurance from a fixed dollar co-pay, and that can drive up the cost of medications. 

For example, most plans used to charge $47 for a tier 3 medication. If a med costs $600, and your plan moved to a 25% coinsurance for T3 meds, that’s now $150 per refill instead of $47.

However, if your med costs $120, that’s now a $30 coinsurance rather than $47, so it can work both ways. 

In addition, CMS (the government agency that administers Medicare) has been negotiating to reduce the cost of the most common, expensive drugs. Drugs like Eliquis, Farxiga, Jardiance, and Januvia (among others) had prices reduced in 2026. For 2027 the drugs include GLP1s like Ozempic, Rybelsus and Wegovy, COPD treatments Trelegy Ellipta and Breo Ellipta, diabetes drug Tradjenta, and others. However, even with reduced pricing, if your plan moved to a percent coinsurance, your out of pocket cost could still rise. 

So the short answer is it’s hard to tell you whether or not the cost your specific mix of medications will go up since there are many moving pieces to the calculation. My advice would be to work with your agent or use the cost estimator at medicare.gov to track your estimated costs. When we get to annual enrollment in October the 2027 drug prices should be loaded into the systems, and medication cost should be one of the pieces of your healthcare puzzle your agent takes into consideration when making plan recommendations.

Greg Strasma · Answer

You can check that two ways.  You can call your Medicare Agent directly.  Or you can call the Insurance Company Customer Service dept and ask them.

Joni Kattau · Answer

You can visit Medicare.gov to search for Prescription Drug Plans in your zip code. You will need to enter the names and dosages of each or your prescriptions and the website can help you compare costs. You can also schedule a meeting with a benefits center or an independent broker. We will also need your prescriptions and dosages and we can look up your drug costs for 2026.

Answered by Joni Kattau on November 8, 2025

Broker Licensed in TX & AZ

Answered by Joni Kattau Medicare Insurance Agent

Andrew Dooly · Answer

The best way to know is to review your plan each year. Prescription costs can change each year based on things like your plan’s formulary, pharmacy, and the tier your medications are placed on. Even if you stay on the same plan, those details can change and affect what you pay.

A best practice is to compare your current medications against next year’s plan information during the Annual Enrollment Period. Many people also find it helpful to review this with a local Medicare agent who can run the comparisons and make sure there aren’t better options available for the upcoming year.

Cynthia Haworth · Answer

A good licensed agent has access to ALL prescription drug costs. I always give print outs of costs before enrolling a client and show which plan is more cost efficient. That way, there are no surprises.

Answered by Cynthia Haworth on February 3, 2026

Agent Licensed in TX

Answered by Cynthia Haworth Medicare Insurance Agent

Zachary Swiger · Answer

It is always important to do an annual review of your coverage this is where you will discover these changes. You can consult your insurance company, Medicare.gov, or your Local Insurance Broker. The insurance broker is my preferred option because they not only can tell you what's changing with your policy, they watch the market and can tell you if there is an option that covers your medications more than your current insurance.

Answered by Zachary Swiger on October 13, 2025

Broker Licensed in MO

Answered by Zachary Swiger Medicare Insurance Agent

Brenda Craine · Answer

You can check the price of your prescriptions for next year by logging into your insurance account and checking the price.

Emily Gelatt · Answer

Talk to a licensed agent or reach out to your plan to do a review of your medication costs. Costs for next year are unknown at this time.

How do I know if my prescriptions will cost more next year?

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How do I know if my prescriptions will cost more next year?

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