Open Enrollment for Medicare Part D (prescription drug coverage) is here again, running October 15 – December 7, 2025, for the 2026 plan year. This year is especially complicated: some plans are disappearing, premiums are changing, and deductibles are shifting. If you (or a family member) rely on Medicare prescription drug coverage, here’s a roadmap to make sure you’re in the right plan for 2026.
Step 1: Go to Medicare.gov
The most reliable tool is right at your fingertips: Medicare.gov.
- Click “Find Plans”
- Enter your ZIP code, pharmacy, and your prescription drugs
- Medicare’s tool will show you which plans cover your drugs, at what cost, and with which pharmacies.
This is critical — don’t guess. Plans differ dramatically in how they treat the same drug.
Step 2: Understand the Deductible Rules
For 2026, many California drug plans will come with a $615.00 deductible (that’s the amount you pay out-of-pocket before the plan starts sharing costs). But plans apply this deductible differently:
- Some plans apply the deductible to all drug tiers (including generics).
- Others apply it only to brand-name or higher-tier drugs.
Translation: If you mostly take Tier 1 or Tier 2 generics, you may find a plan where your deductible doesn’t apply — so you get co-pays right away.
Step 3: Compare Your Choices Before December 7
You must make your decision by December 7. After that, you’re locked in (or out) until the next Open Enrollment. Here’s what to look at when comparing plans:
- Monthly premium (what you pay each month for the plan)
- Deductible (what you pay before coverage kicks in)
- Drug costs (your co-pay or coinsurance for each medication)
- Pharmacy network (make sure your preferred pharmacy is covered)
- Customer service reputation (some carriers are much easier to work with)
Step 4: Two Options Worth Highlighting in California
- WellCare Value Script – This is typically the lowest-cost plan for many Californians. It offers low or $0 co-pays for Tier 1 and Tier 2 generics, which makes it attractive if you only take a few basic medications. $5.70 a month
- HealthSpring (formerly CIGNA) Extra RX – likely the best bet for those with multiple drugs and access to some Teir 1 and Tier 2 drugs before the deductible. $70.60 a month
- AARP MedicareRx Preferred – While more expensive, this plan usually has the broadest formulary (drug list) and better customer service. If you’re on multiple or brand-name medications, this plan may be worth the peace of mind. $165 a month
Step 5: Don’t Wait Until the Last Minute
Every year, people put this off until December and end up rushing. Do yourself a favor:
- Run your drugs on Medicare.gov now.
- Select a plan and enroll online – or you can call the carrier directly to discuss access to a specific drug.
- Enroll before December 7 to avoid surprises.
A Word About Agents
Unlike Medicare Advantage or Medigap plans, Part D prescription drug plans are not agent-driven products. That means licensed insurance agents can’t really “fix” or “customize” your drug plan. Think of agents like people patching flat tires — we can advise you, but the enrollment is really up to you, directly through Medicare.gov or the plan.
Bottom Line
For 2025, Medicare drug coverage in California is more complex than ever. Some plans are disappearing, prices are shifting, and deductibles are higher. The good news: if you take 30 minutes to use the Medicare Plan Finder tool, you can make sure you’re not overpaying and that your drugs are covered the way you need.
Deadline: December 7, 2024. Don’t miss it.
