Part D penalty calculator
See what going without drug coverage adds to your Part D premium — for as long as you keep it.
Medicare Part D
Medicare Part D prescription drug insurance solutions
Part D is prescription drug coverage. Choosing one by its monthly premium is the most common and most expensive mistake in Medicare, because the premium is rarely the number that decides your yearly cost.
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Every Part D plan publishes a formulary — the list of drugs it covers and the tier each drug sits on. Two plans can have the same premium and produce wildly different bills for the same person, because one puts your medication on tier 2 and the other on tier 4, or requires prior authorisation, or only prices it well at a pharmacy across town.
The right way to choose is to work from your actual prescription list. Sarah enters each drug with its dosage, checks how every available plan tiers it, and prices it at the pharmacies you would realistically use, including mail order. What comes out is a total estimated yearly cost — premium plus deductible plus what you will actually pay at the counter — and that is the number worth comparing.
Part D has changed meaningfully in recent years. There is now an annual cap on what you pay out of pocket for covered drugs, and a payment option that lets you spread that cost across the months of the year instead of absorbing it in one hit. Whether the smoothing option helps you depends on your drugs and when in the year you fill them — it is worth a conversation rather than a guess.
There is also a penalty worth avoiding. If you go 63 days or more without creditable drug coverage after you are first eligible, Medicare adds a permanent surcharge to your Part D premium for as long as you have it. People who take no medications are the ones most likely to be caught by this, because skipping Part D feels sensible at the time.
What's included
- Every prescription entered with dosage and checked against each plan's formulary and tier
- Priced at your pharmacy — plus mail order, where it often lands cheaper
- Total estimated yearly cost compared, not the monthly premium
- Prior authorisation, step therapy and quantity limits flagged before you enroll, not after a rejected claim
- The annual out-of-pocket cap and the monthly payment-smoothing option explained for your situation
- Late-enrollment penalty explained and avoided — it is permanent once it attaches
Carriers we work with
Carriers we compare
Medicare carriers
- Devoted Health
- HealthSpring (Cigna)
- Humana
- Molina
- SelectHealth
- UnitedHealthcare
Important: We do not offer every plan available in your area. Currently we represent 8 organizations which offer 72 products in your area. Please contact Medicare.gov, 1-800-MEDICARE to get information on all of your options.
Tools
Run the numbers first
Free calculators for this coverage. Instant results in your browser — estimates, not quotes.
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FAQ
Medicare Part D — common questions
I take no prescriptions. Do I still need a Part D plan?
Usually yes, and this is where people get hurt. If you go without creditable prescription coverage for 63 days or more after you become eligible, Medicare adds a late-enrollment penalty to your premium permanently. A low-premium plan now is insurance against both an unexpected prescription and a surcharge you would carry for life.
What if one of my prescriptions is not on the plan’s formulary?
You can request a formulary exception with your prescriber’s support, ask about a covered alternative, or choose a different plan at the next enrollment window. Formularies differ substantially between plans, which is why the drug list matters more than the premium.
Bring your exact medications — name, dose and frequency — to any comparison. A plan that is cheapest on premium is regularly the most expensive once your actual drugs are priced through it.
Is there a limit on what I pay for drugs in a year?
Yes. Part D now carries an annual out-of-pocket cap on covered drugs, after which covered prescriptions cost you nothing for the rest of the year. The cap amount is set federally and adjusts each year.
There is also an option to spread your out-of-pocket drug costs across the year in monthly payments rather than paying them as they fall. Worth asking about if a January refill is what hurts.
Do I need Part D if I take no prescriptions at all?
Usually yes, and this is where the money is lost. Going without creditable drug coverage builds a late enrollment penalty of 1% of the national base premium per uncovered month, added to your premium for as long as you have Part D.
A low-premium plan taken now is generally cheaper than the permanent penalty later. Our Part D penalty calculator shows what a given gap would cost.
What does it cost to work with CUPS Insurance on Medicare Part D?
Nothing. Carriers pay a commission when a plan is issued, and that commission is already built into the plan price whether you use an agent or not.
Buying the same plan on your own does not make it cheaper — it just means nobody checked your doctors and prescriptions first, and nobody picks up the phone in March when something goes wrong.
Does CUPS Insurance offer every plan available for Medicare Part D?
No, and no agency does. We are independent, which means we compare across the carriers listed on this site rather than representing a single one — but that is not the same as offering every plan on the market.
We do not offer every plan available in your area. Currently we represent 8 organizations which offer 72 products in your area. Please contact Medicare.gov, 1-800-MEDICARE to get information on all of your options.
Who will actually be helping me?
Sarah Wood Rodriquez, licensed since 2009 — over 17 years — and licensed in Utah, Arizona, Idaho. NPN 14943086.
The person who answers the phone is the person who reviews your plan. There is no call center and no handing you between departments.
How do I get started with Medicare Part D?
Call Sarah, a licensed insurance agent, at 435-292-8777 (TTY 711) or book a call. The first conversation usually runs twenty to thirty minutes and there is nothing to sign.
Bring your prescription list and your doctors’ names — with those, the comparison can be a real one rather than a generic one.
Learn
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Grab a cup. Let's make insurance make sense.
A real conversation with a licensed agent who will check your doctors and prescriptions before you decide — and answer the phone all year after that.
Book a call with Sarah Call 435-292-8777 Speak with a licensed insurance agent · TTY 711
Office hours: 10:00 AM – 5:00 PM · Ogden, Utah · NPN 14943086