What is a standalone Medicare Part D Prescription Drug Plan (PDP)?

A standalone Medicare Part D plan (PDP) is a private insurance plan that adds prescription drug coverage to Original Medicare (Part A and Part B). These plans are often paired with a Medicare Supplement (Medigap) policy to provide comprehensive healthcare coverage.

How much will I pay out-of-pocket for Part D drugs in 2026?

Starting in 2025 and continuing through 2026, there is a $2,000 (indexed to $2,100 for 2026) annual out-of-pocket cap on covered prescription drugs. Once you reach this limit, you will pay $0 for the remainder of the year for all covered medications.

What is the Part D 'Donut Hole' and does it still exist?

The Part D 'Donut Hole' or coverage gap has been officially eliminated as of 2025. The drug benefit has been simplified into three phases: the deductible, the initial coverage phase, and the catastrophic phase where your costs drop to zero after meeting the out-of-pocket cap.

Can I pay my Part D costs in monthly installments?

Yes. The new Medicare Prescription Payment Plan allows Nevada residents to opt-in to a program that spreads their out-of-pocket drug costs into monthly payments throughout the year, rather than paying large amounts all at once at the pharmacy.

What is a Part D Formulary?

A formulary is a list of covered drugs specific to each Medicare Part D plan. Drugs are typically categorized into 'Tiers,' where lower tiers (Tier 1 and 2) represent low-cost generics and higher tiers represent brand-name or specialty medications.

How do I avoid the Part D Late Enrollment Penalty in Nevada?

To avoid the lifetime penalty, you must enroll in a Part D plan when you first become eligible at age 65, unless you have 'creditable' drug coverage through an employer or another source that is as good as Medicare's standard benefit.

Part D Plans

Medicare Part D plans protect you from paying full retail price for your prescriptions — instead, you pay only the copays your plan requires. In Nevada, Part D plans are available as standalone coverage alongside Original Medicare, or built into a Medicare Advantage plan. With dozens of plans available in each county and every plan carrying a different formulary, choosing the right one without help often means paying more than you have to.

Nevada Medicare compares every Part D plan available in your zip code against your exact medications — completely free. Call 702-840-1111 today.

Companies Offering Medicare Part D Plans

The biggest brand name companies in the health insurance industry offer Part D Plan. This includes name brands like Humana, Aetna, Blue Cross and Blue Shield, United Healthcare and more. There are also a number of companies you may not have heard of before you were eligible for Medicare, such as Silverscript or Express Scripts.

Choosing a Medicare Part D plan seems easy but many people tell us that they are confused by too many choices or simply how they work. Others have had to switch plans because they were put in the wrong plan. The worst thing that can happen is you get enrolled in a plan but you won’t realize it’s the wrong plan until you use it. Hence, you are stuck with the plan and the out of pocket costs until you can change out of it once a year during the Annual Enrollment Period that happens from October 15th thru December 7th.

The best way to find the right plan that matches you is to have a licensed advocate at Nevada Medicare assist you. We use Medicare’s Drug Plan Finder tool to analyze the plans offered in Nevada. We have an exclusive database that tells us which plans will give you the lowest annual out of pocket spending.

Do I Have to Enroll in a Part D Plan?

No. Medicare Part D coverage is optional, but if you don’t enroll in Part D as soon as you’re eligible, you might pay a late-enrollment penalty if you enroll later.

What Happens If I Don’t Enroll in Part D When I am First Eligible?

If you fail to enroll in Part D during your Medicare Initial Enrollment Period, you will have to wait for a future Annual Election Period to enroll, which means you could be without coverage for months after a diagnosis of an illness before you can get into a plan. You will also be assessed a late penalty later on when you do enroll. The only exception to this is if you didn’t enroll is because you had other creditable drug coverage, like employer coverage or VA benefits.

The Medicare Part D Late Enrollment Penalty

The late enrollment penalty is an amount added to your Medicare Part D monthly premium.

You may owe a late enrollment penalty if, for any continuous period of 63 days or more after your Initial Enrollment Period is over, you go without one of these:

A Medicare Prescription Drug Plan (Part D)
A Medicare Advantage Plan (Part C) (like an HMO or PPO) or another Medicare health plan that offers Medicare prescription drug coverage
Creditable prescription drug coverage

The penalty is calculated by Medicare as follows:

1% of the national average base Part D premium for every month that you went uncovered and did not have other creditable coverage. The penalty is rounded to the nearest $.10, and then added to the premium you pay for your new Part D premium.

More importantly, if you miss your window, you cannot buy a drug plan mid-year without a special circumstance. Imagine if you develop a serious health condition in March and you need a very expensive medication for it. You would pay the full retail cost of that medication until the next Part D annual election period – the earliest you could sign into a plan would be October 15th. This means you would have no coverage until January 1st. The true risks of being uninsured is unimaginable.

The base premium for 2020 is around $32.74, so if you had waited 24 months to enroll in Part D, you would have a penalty of 24%. That translates to $7.85 added to your chosen Part D plans’ premium. When you do finally enroll in Part D, you will pay this penalty every month.

How long do you pay this penalty for? The penalty that the government will impose on you is Lifetime. This means you would be paying this for as long as you live.

Late Enrollment Scenarios

Example: Mrs. Goodrich’s Initial Enrollment Period ended May 31, 2022. She had no creditable drug coverage and didn’t enroll until the Annual Election Period ending December 7, 2024. Her coverage began January 1, 2025.

Since she went without creditable coverage from June 2022 through December 2024 — 31 months — her late enrollment penalty is 31%.

Here’s the math:
.31 (31% penalty) × $36.78 (approximate 2026 national base premium) = $11.40
Rounded to the nearest $0.10 = $11.40 added to her monthly premium — every month, for life.

This is why enrolling on time matters. Call 702-840-1111 and we’ll make sure you never miss your window.

Do I get an ID Card for Prescription Drugs?

Yes, you will receive an ID card for your Part drug plan. So if you have a Supplement plan you will have your Medicare Part A/B ID Card, Supplement Plan ID card and Part D prescription drug plan ID Card. If you only have a standalone Part D and Original Medicare, you will only have your Part D prescription drug plan ID Card and your Medicare Part A/B ID Card.

Be aware as well that most of the time, your Medicare Part D plan can be with a different insurance company than your Supplement plan. This is normal.

Keep in mind though that there are Medicare Advantage plans that have a Part D drug plan built-in them already – this means you only get one ID card for everything.

Medicare Part D

Not sure if Medicare Advantage is right for you?

We compare every plan available in your Nevada county — checking your doctors, your medications, and your budget — at no cost. Call Nevada Medicare at 702-840-1111 or visit us at 2412 Stewart Ave, Las Vegas, NV 89101.

Part D Plans

Medicare Part D

Not sure if Medicare Advantage is right for you?

“We Help People”

Company

Business Hours