Insurance Services | T. French Insurance Agency LLC

Prescription drugs are one of the biggest health care costs most seniors face in retirement. That’s why Medicare Part D exists — it’s designed to make medications more affordable. But with dozens of plan choices, changing formularies, and shifting rules each year, Medicare Part D can quickly become one of the most confusing parts of the Medicare journey.

At Medicare Plan Advocates Inc., we know how overwhelming this process can feel. Recent policy changes have made it even harder for seniors to get trusted help reviewing Part D plans. That’s why we’re here: to restore the one-on-one guidance you need to make confident decisions about your drug coverage.

What Is Medicare Part D?

Medicare Part D is prescription drug coverage available to anyone with Medicare. It is provided by private insurance companies approved by Medicare, not by Medicare itself.

You can get Part D coverage in two ways:

As a stand-alone plan (for those on Original Medicare).
Bundled with a Medicare Advantage plan (Part C).

Part D plans cover both generic and brand-name prescriptions, though the specific drugs covered and the costs depend on the plan you choose.

Why Medicare Part D Matters

Without Part D, seniors are often forced to pay the full retail cost of their medications. For many, this could mean hundreds or even thousands of dollars per month — especially for specialty or high-cost prescriptions.

A well-chosen Part D plan can:

Lower out-of-pocket drug costs.
Protect against unexpected expenses.
Provide peace of mind with predictable monthly coverage.

How Medicare Part D Works

Each Part D plan has its own rules and cost structure. Here are the basics every senior should understand:

Premium: A monthly payment for the plan (varies by carrier).
Deductible: The amount you pay before coverage begins. Some plans waive this for generics.
Copays/Coinsurance: What you pay for prescriptions at the pharmacy.
Formulary: Each plan has its own list of covered drugs.
Pharmacy networks: Some pharmacies are “preferred,” meaning lower costs if you fill prescriptions there.

👉 This is where independent support is critical. Medicare.gov lists plans, but it doesn’t always make it easy to compare the fine details that can affect your budget.

The “Donut Hole” Explained

One of the most confusing aspects of Part D is the coverage gap, often called the “donut hole.”

Here’s how it works:

You pay your deductible and normal copays until you and your plan spend a certain amount on covered drugs.
Once that threshold is reached, you enter the coverage gap where you may pay a larger share of drug costs.
After reaching the annual out-of-pocket maximum, you move into catastrophic coverage, where your costs drop significantly.

While recent legislation has closed much of the donut hole, seniors can still experience spikes in out-of-pocket expenses depending on the drugs they take.

Common Mistakes Seniors Make With Part D

Not reviewing plans annually – Formularies and costs change every year. The plan that worked last year may not be the best this year.
Choosing based only on premium – A low premium may look attractive but could lead to higher drug costs overall.
Ignoring pharmacy networks – Using a non-preferred pharmacy can cost significantly more.
Not checking drug tiers – A medication’s tier affects your copay or coinsurance.
Skipping Part D altogether – If you don’t enroll when eligible, you could face lifetime penalties.

Why Seniors Are Struggling More Today

In the past, many seniors relied on licensed insurance agents to review Part D plans. But with policy changes that eliminated commissions for stand-alone drug plans, many agents are no longer providing this service.

That’s left countless seniors to figure it out alone — scrolling through Medicare.gov with no one to guide them.

At Medicare Plan Advocates Inc., we saw this need and built a service to fill the gap.

How Medicare Plan Advocates Inc. Helps With Part D

Here’s what sets our approach apart:

Personalized plan reviews – We don’t just hand you a list. We walk you through your options step by step.
Cost-saving research – We analyze your actual prescriptions and pharmacies to find where you can save.
Carrier calls on your behalf – If something isn’t clear, we don’t leave you hanging. We call the carriers directly.
Specialized expertise – We handle complex cases, including high-cost specialty medications, with care and attention.

We’re not selling insurance. We’re providing independent, unbiased guidance so you can make the best choice for your health and budget.

Meet Your Advisor: Kristin Muller

Behind our mission is Kristin Muller, a Colorado native, wife, and mom of four. With a background in problem-solving, organization, and service, Kristin brings compassion and clarity to every client conversation.

Her goal is simple: to make sure no one has to navigate Medicare Part D alone.

Call to Action: Review Your Drug Plan Today

If you’re unsure whether your current Medicare Part D plan is the right fit, don’t wait until costs surprise you at the pharmacy.

Disclaimer

Medicare Plan Advocates Inc. is an independent service and is not affiliated with Medicare.gov, the Centers for Medicare & Medicaid Services (CMS), or the U.S. government. Information in this blog is for educational purposes only. For official Medicare information and enrollment, please visit www.Medicare.gov

Medicare Part D: What Every Senior Needs to Know About Prescription Drug Coverage