Log In to Medicare.gov and Check.
Medicare Part D drug plans organize every covered medication into tiers — numbered categories that determine your copay. A drug on Tier 1 might cost you $0 to $5. The same drug reclassified to Tier 3 or Tier 4 by your plan could cost you $42 to several hundred dollars for the same fill. Plans are allowed to move drugs between tiers at annual renewal — and they do. Most people never notice until they see a higher number at the pharmacy counter and assume the price went up.
What the Tier System Looks Like
Typical 2026 Part D tier copay ranges. Actual amounts vary by plan. Sources: Medicare.gov Plan Finder; CoveredUSA Part D Tier Guide 2026; Association for Accessible Medicines 2025.
How to Check Your Plan in 10 Minutes
Go to Medicare.gov and log into your account, or call 1-800-MEDICARE (1-800-633-4227). Use the Plan Finder tool to look up your current plan by name and check the formulary — the list of covered drugs and their current tiers. Search each medication you take and note its tier. If any medication moved to a higher tier since last year, you have options worth exploring.
If a medication is on Tier 3 or Tier 4, ask your doctor whether a Tier 1 or Tier 2 alternative in the same drug class would work equally well for your condition. In many cases it will, and the switch can reduce your annual prescription cost by hundreds of dollars. You can also request a coverage exception from your plan asking that a drug be covered at a lower tier — your doctor can submit supporting documentation to strengthen the request.
If you are approaching Medicare's open enrollment window (October 15 to December 7 each year), checking your drug tiers before that deadline gives you the information needed to compare plans and potentially switch to one that covers your medications at a lower cost for the coming year.
With care,
Mike Bridges
Founder, The O55 Report