Your Prescriptions, Priced on Every Available Plan — Before You Enroll
Medicare Part D is prescription drug coverage, and the right plan isn't the one with the lowest monthly premium — it's the one built around the specific drugs you actually take. I run your prescriptions through every available Part D plan in your area before recommending one, so you know your real out-of-pocket costs before you're locked in.
What We Offer
How Part D Fits Into Your Medicare Coverage
Part D works differently depending on how you get your Medicare. If you have Original Medicare paired with a Medicare Supplement plan, you'll need a standalone Part D prescription drug plan to cover your medications. If you're enrolled in a Medicare Advantage plan, prescription drug coverage is typically bundled in — though the formulary still varies significantly by plan and carrier.
Either way, the plan you're on matters. Two Part D plans with identical monthly premiums can produce wildly different annual drug costs depending on how each plan tiers your specific medications. A drug covered at Tier 1 on one plan might sit at Tier 3 on another, and that gap adds up fast.
What I Do Before You Enroll in a Part D Plan
Most people choose a Part D plan based on the premium. That's the wrong starting point. Here's how I approach it:
- I collect your current prescription list, including dosages and fill frequency.
- I run your medications through every available Part D plan in your Wisconsin zip code.
- I compare total annual cost — premium plus your estimated drug costs at each plan's formulary tier.
- I flag any preferred pharmacy networks that could reduce your cost-sharing further.
- I walk you through the results in plain language and recommend the plan that fits your prescriptions and your budget.
The difference in annual out-of-pocket drug costs between the cheapest and most expensive plan for your specific medications can run into the hundreds of dollars. That comparison takes me time. It costs you nothing.
The Late Enrollment Penalty — and Why It Matters
One of the most common and costly Medicare mistakes I see is delaying Part D enrollment. If you don't sign up for a Medicare prescription drug plan when you first become eligible and you don't have other creditable drug coverage through an employer or union plan, you'll face a late enrollment penalty.
That penalty is calculated as 1% of the national base beneficiary premium for every month you went without creditable coverage. It gets added to your Part D premium permanently — for as long as you're enrolled in Medicare. Missing 12 months means a 12% premium increase that never goes away.
If you've already missed your initial enrollment window, don't wait longer. I help clients understand where they stand, what the penalty looks like in real dollars, and how to get covered now to stop it from growing.
Part D Formularies Change Every Year — So Does My Review
Enrolling in a good Part D plan this year doesn't mean it's still the right plan next year. Carriers adjust their formularies annually — drugs move between tiers, preferred pharmacy networks shift, and coverage terms change. A plan that covered your medications at a low tier in 2024 may not do the same in 2025.
Every September, carriers send an Annual Notice of Change letter outlining what's different for the coming year. Most people set it aside without reading it. Before the Annual Enrollment Period opens each fall, I review every current client's Part D plan against the updated formulary to catch changes before they cause a problem. If a better plan exists for your prescriptions, I'll find it and walk you through switching.
This is part of how I work with clients — not a separate service, not an upsell. If you're already working with me, your plan gets reviewed every year.
Who Needs a Standalone Part D Plan
A standalone Medicare Part D prescription drug plan is the right fit if you're enrolled in Original Medicare, with or without a Medicare Supplement plan. Here's a quick look at who this applies to:
- Adults turning 65 who are enrolling in Original Medicare and want separate drug coverage
- Current Medicare enrollees on a Supplement plan who don't yet have Part D
- Anyone who dropped a Medicare Advantage plan and returned to Original Medicare
- Individuals who had employer drug coverage that is ending or is no longer considered creditable
If you're on a Medicare Advantage plan that already includes drug coverage, a standalone Part D plan generally isn't something you'd add. But if you're ever considering switching between Medicare Advantage and Original Medicare, Part D enrollment timing matters — and that's exactly the kind of transition I help clients navigate carefully.
Clients across Dane County — including those I work with in Madison, Middleton, Verona, and Sun Prairie — often have different plan options available depending on their zip code. I run the comparison for your specific area before making any recommendation.
Common Questions About Medicare Part D
Do I need Part D if I have Medicare Advantage?
Most Medicare Advantage plans include prescription drug coverage, so a separate standalone Part D plan typically isn't needed. However, coverage varies by plan, and the formulary matters just as much as it does with standalone Part D. If you're comparing Advantage plans, I'll include drug coverage in that analysis.What happens if I don't enroll in Part D when I first become eligible?
If you go without creditable prescription drug coverage after becoming eligible for Medicare, you'll face a late enrollment penalty — 1% of the national base premium for every month you delayed. That penalty is added to your Part D premium permanently. The longer you wait, the larger it grows.Can I switch Part D plans every year?
Yes. The Annual Enrollment Period runs from October 15 through December 7 each year. During that window, you can switch from one Part D plan to another, and your new coverage takes effect January 1. This is exactly why I review every client's plan each fall before AEP closes.How do I find the best Part D plan for my prescriptions in Wisconsin?
The most accurate way is to run your specific medications through every available plan in your zip code and compare total annual cost — not just the monthly premium. That's what I do for every client before enrollment. No online calculator gives you the full picture the way a side-by-side formulary comparison does.What is a formulary, and why does it matter?
A formulary is the list of drugs a plan covers, organized into tiers that determine your cost-sharing. A drug on Tier 1 costs you very little. The same drug on Tier 3 or Tier 4 can cost significantly more. Plans don't all cover the same drugs at the same tiers, which is why two plans with similar premiums can produce very different annual costs for the same person.
Ready to Find the Right Part D Plan for Your Prescriptions?
Whether you're enrolling in Medicare Part D for the first time, approaching an Annual Enrollment Period, or concerned about a late enrollment penalty, I'm here to help you sort it out without the pressure. I'll compare every available Medicare prescription drug plan in Wisconsin against your specific medications — and explain what I find in plain language.