Compare & Enroll — Part C & Part D

Compare & Enroll in Medicare Plans in 20742, MD

With 34 Medicare Advantage options from 8 insurers, 20742, MD has fewer plan options than the national average, suggesting a highly competitive market where insurers often lower premiums to attract members. Approximately 79% of local MA plans charge $0 beyond the standard Part B premium, reflecting strong price competition. With 10 hospitals within 25.0 miles, most local plan networks should offer strong provider access. We've organized the CMS data below to help you cross-reference plan costs, quality ratings, and local provider access. Compare plans below, and when you're ready, enroll directly at Medicare.gov.

📊 Direct from CMS 🚫 No agents or commissions ✓ Just the data, no sales pitch
Compare Plans at Medicare.gov →

Data freshness: CMS data as of February 2026 • ACS data as of 2023 • Reviewed & approved on 2026-02-16
Reviewed by: Wes Ward, Founder & Data Lead • View our methodology

Important: We are not affiliated with Medicare or any government agency. This site displays publicly available CMS data to help you compare plans. We do not sell insurance or represent any insurance company. For official enrollment and complete plan information, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).

Important: Plan availability, benefits, and CMS Star Ratings shown here come directly from CMS public files. Plan details can change—always verify with the insurer and at Medicare.gov.
Part C Plans
34
Part D Plans
10
Top MA Star
5.0
Top Drug Star
3.5
Happy senior couple reviewing Medicare plan options together

Medicare Eligibility in 20742, MD

Approximately 289 residents (2.5% of the population) in 20742, MD are 65 or older and likely Medicare-eligible. Whether you're approaching 65, already enrolled, or a caregiver comparing options, the plan data below is organized to help you evaluate Part C (Medicare Advantage) and Part D (prescription drug) coverage side by side.

The median household income in 20742, MD is $30,611 (59.3% below the National Average), which may affect eligibility for Extra Help with Part D drug costs.

Part C: Medicare Advantage Plans

Medicare Advantage (Part C) replaces Original Medicare through private insurers who bundle hospital, medical, and often drug coverage into a single plan. 20742, MD's 34 Medicare Advantage plans are predominantly HMO-based (23 HMO vs. 11 PPO), meaning most require referrals and in-network care. 27 plans offer $0 monthly premiums. The average local star rating is 3.9 out of 5, with the top plan earning 5.0 ★.

Top Medicare Advantage Plans in 20742, MD

We organize CMS plan data into separate leaderboards so you can compare based on what matters most to you. Part C premiums in 20742, MD range from $0 to $72/month. Among rated plans, 14 plans rated 4+ stars, including 6 with perfect 5-star ratings.

Highest CMS Star Ratings

Star Ratings are assigned by CMS based on quality measures including customer service, preventive care, and managing chronic conditions.

Plan NameInsurerStar RatingPremiumType
Erickson Advantage Signature (HMO-POS)Unitedhealthcare5.0 ★$8.30/moHMO-POSEnroll
Erickson Advantage Guardian (HMO-POS I-SNP)Unitedhealthcare5.0 ★$0.00/moHMO-POS I-SNPEnroll
Erickson Advantage Champion (HMO-POS C-SNP)Unitedhealthcare5.0 ★$62.50/moHMO-POS C-SNPEnroll
Erickson Advantage Freedom (HMO-POS)Unitedhealthcare5.0 ★$0.00/moHMO-POSEnroll
Erickson Advantage Liberty (HMO-POS)Unitedhealthcare5.0 ★$0.00/moHMO-POSEnroll

Lowest Monthly Premium

Lower premiums can save money, but check total costs including deductibles, copays, and MOOP.

Plan NameInsurerMonthly PremiumMOOPStar Rating
Kaiser Permanente Medicare Advantage Value 1 Md (HMO)Kaiser Permanente$0.00/mo$8,2004.0 ★
Humanachoice H7617-044 (PPO)Humana$0.00/mo$7,5504.5 ★
Carefirst Bluecross Blueshield Advantage Essential (PPO)Carefirst Bluecross Blueshield Medicare Advantage$0.00/mo$8,3003.5 ★
Humanachoice H5216-376 (PPO)Humana$0.00/mo$7,5503.5 ★
Uhc Dual Complete Md-S002 (HMO D-SNP)Unitedhealthcare$0.00/mo$9,2503.5 ★

Lowest Maximum Out-of-Pocket (MOOP)

MOOP caps your financial risk. Once you hit this limit, the plan covers 100% of covered services for the rest of the year.

Plan NameInsurerMOOP (In-Network)PremiumStar Rating
Erickson Advantage Guardian (HMO-POS I-SNP)Unitedhealthcare$1,000$0.00/mo5.0 ★
Erickson Advantage Signature (HMO-POS)Unitedhealthcare$2,900$8.30/mo5.0 ★
Erickson Advantage Champion (HMO-POS C-SNP)Unitedhealthcare$3,400$62.50/mo5.0 ★
Erickson Advantage Freedom (HMO-POS)Unitedhealthcare$4,900$0.00/mo5.0 ★
Kaiser Permanente Medicare Advantage High Md (HMO-POS)Kaiser Permanente$5,700$71.70/mo4.0 ★

Plan Type Mix in 20742, MD

HMO plans require referrals and in-network care. PPO plans offer more flexibility. SNP (Special Needs Plans) serve specific populations. MAPD plans include drug coverage.

Plan TypeCountPercentageDescription
PPO823.5%No referrals; in and out-of-network
HMO D-SNP617.6%Medicare Advantage plan
HMO617.6%Requires referrals; in-network only
HMO-POS617.6%HMO with some out-of-network options
PPO D-SNP25.9%Medicare Advantage plan
HMO I-SNP25.9%Medicare Advantage plan
HMO C-SNP12.9%Medicare Advantage plan
HMO-POS C-SNP12.9%Medicare Advantage plan
HMO-POS I-SNP12.9%Medicare Advantage plan
PPO I-SNP12.9%Medicare Advantage plan

Choosing the Right Medicare Advantage Plan

The best Part C plan depends on your doctors, medications, and budget. Key factors to evaluate:

  • Provider network: Verify your doctors and hospitals near 20742, MD are in-network before enrolling
  • Total cost: A $0 premium may have higher copays—calculate your annual cost
  • Star Ratings: 4+ stars indicate above-average quality and member satisfaction

Read our full guide on choosing Medicare Advantage → · Print our enrollment checklist →
Medicare Glossary: HMO, PPO, MOOP & more →

Medicare Advantage Insurers in 20742, MD

8 insurance companies offer Medicare Advantage plans in 20742, MD. Below, we group plans by insurer so you can compare options from each company. More insurers generally means more competition and better benefits for consumers.

Unitedhealthcare
Avg Star Rating
4.7 ★
8 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Erickson Advantage Liberty (HMO-POS)
$0.00/mo
$6,750
5.0 ★
HMO-POS
Erickson Advantage Freedom (HMO-POS)
$0.00/mo
$4,900
5.0 ★
HMO-POS
Erickson Advantage Guardian (HMO-POS I-SNP)
$0.00/mo
$1,000
5.0 ★
HMO-POS I-SNP
Erickson Advantage Liberty No Rx (HMO-POS)
$0.00/mo
$6,750
5.0 ★
HMO-POS
Uhc Nursing Home Plan Ex-F004 (PPO I-SNP)
$0.00/mo
$9,250
4.0 ★
PPO I-SNP
Uhc Dual Complete Md-S002 (HMO D-SNP)
$0.00/mo
$9,250
3.5 ★
HMO D-SNP
Erickson Advantage Signature (HMO-POS)
$8.30/mo
$2,900
5.0 ★
HMO-POS
Erickson Advantage Champion (HMO-POS C-SNP)
$62.50/mo
$3,400
5.0 ★
HMO-POS C-SNP
Kaiser Permanente
Avg Star Rating
4.0 ★
6 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Kaiser Permanente Dual Essential Plan 1 Md (HMO D-SNP)
$0.00/mo
$9,250
4.0 ★
HMO D-SNP
Kaiser Permanente Dual Complete Plan 1 Md (HMO D-SNP)
$0.00/mo
$9,250
4.0 ★
HMO D-SNP
Kaiser Permanente Medicare Advantage Liberty (HMO)
$0.00/mo
$5,900
4.0 ★
HMO
Kaiser Permanente Medicare Advantage Value 1 Md (HMO)
$0.00/mo
$8,200
4.0 ★
HMO
Kaiser Permanente Medicare Advantage Standard 1 Md (HMO-POS)
$24.60/mo
$7,900
4.0 ★
HMO-POS
Kaiser Permanente Medicare Advantage High Md (HMO-POS)
$71.70/mo
$5,700
4.0 ★
HMO-POS
Humana
Avg Star Rating
3.6 ★
7 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Humanachoice H5216-376 (PPO)
$0.00/mo
$7,550
3.5 ★
PPO
Humanachoice Snp-De H5216-377 (PPO D-SNP)
$0.00/mo
$9,250
3.5 ★
PPO D-SNP
Humanachoice H7617-044 (PPO)
$0.00/mo
$7,550
4.5 ★
PPO
Humana Usaa Honor Giveback (PPO)
$0.00/mo
$6,750
3.5 ★
PPO
Humanachoice Snp-De H5216-459 (PPO D-SNP)
$0.00/mo
$9,250
3.5 ★
PPO D-SNP
Humana Usaa Honor Giveback (PPO)
$0.00/mo
$6,750
3.5 ★
PPO
Humanachoice H5216-387 (PPO)
$36.20/mo
$7,550
3.5 ★
PPO
Alterwood Advantage
Avg Star Rating
3.5 ★
6 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Alterwood Advantage Dual Secure (HMO D-SNP)
$0.00/mo
$9,250
3.5 ★
HMO D-SNP
Alterwood Advantage Dual Value (HMO D-SNP)
$0.00/mo
$9,250
3.5 ★
HMO D-SNP
Alterwood Advantage Choice (HMO)
$0.00/mo
$7,500
3.5 ★
HMO
Alterwood Advantage Select (HMO)
$0.00/mo
$7,500
3.5 ★
HMO
Alterwood Advantage Freedom (HMO)
$0.00/mo
$9,250
3.5 ★
HMO
Alterwood Advantage Choice Plus (HMO)
$31.30/mo
$6,500
3.5 ★
HMO
Carefirst Bluecross Blueshield Medicare Advantage
Avg Star Rating
3.5 ★
3 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Carefirst Bluecross Blueshield Advantage Salute (PPO)
$0.00/mo
$5,900
3.5 ★
PPO
Carefirst Bluecross Blueshield Advantage Essential (PPO)
$0.00/mo
$8,300
3.5 ★
PPO
Carefirst Bluecross Blueshield Advantage Complete (PPO)
$9.90/mo
$7,300
3.5 ★
PPO
Carefirst Bluecross Blueshield Medicare Advantage Dual Prime
Avg Star Rating
3.5 ★
1 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Carefirst Bluecross Blueshield Advantage Dualprime (HMO D-SNP)
$0.00/mo
$8,850
3.5 ★
HMO D-SNP
Keycare Advantage
Avg Star Rating
N/A
2 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Keycare Advantage (HMO I-SNP)
$0.00/mo
$8,950
N/A
HMO I-SNP
Keycare Advantage Plus (HMO C-SNP)
$0.00/mo
$6,900
N/A
HMO C-SNP
Communicare Advantage
Avg Star Rating
N/A
1 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Communicare Advantage Isnp (HMO I-SNP)
$0.00/mo
$9,250
N/A
HMO I-SNP

Plan availability, premiums, and benefits shown are based on CMS data and may change. Always verify current details with the insurer and at Medicare.gov before enrolling.

Part D: Prescription Drug Plans (PDP)

Part D covers prescription drugs through standalone plans for those on Original Medicare, or as part of a Medicare Advantage bundle. Among the 10 standalone Part D plans in 20742, MD, some offer $0 annual deductibles while others charge up to the 2026 maximum of $590. 2 plans are at or below the regional premium benchmark, making them eligible for Low Income Subsidy auto-enrollment. The 2026 $2,000 out-of-pocket cap means drug costs are now more predictable regardless of which plan you choose, but formulary coverage still varies significantly—always verify your medications are covered before enrolling.

Part D Formulary Notice: Each Part D plan has its own formulary (list of covered drugs). The same medication may be on different tiers—or not covered at all—depending on the plan. Always check that your specific medications are covered before enrolling.
2026 Out-of-Pocket Cap: Thanks to the Inflation Reduction Act, your total out-of-pocket drug costs are capped at $2,000 per year in 2026. Once you reach this limit, you pay nothing more for covered Part D drugs for the rest of the year. This eliminates the old "donut hole" coverage gap that previously caused higher costs.
Low Income Subsidy (LIS / Extra Help): If you have limited income and resources, you may qualify for Extra Help paying Part D costs. Visit SSA.gov or call 1-800-MEDICARE.

Top Part D Drug Plans in 20742, MD

We organize Part D plans by CMS Star Ratings, premiums, and deductibles so you can find the best fit for your prescription needs. Part D premiums in 20742, MD range from $0 to $109/month. Remember: all Part D plans now cap your annual out-of-pocket drug costs at $2,000 thanks to the Inflation Reduction Act.

Highest CMS Star Ratings (Part D)

Part D Star Ratings measure drug pricing, customer service, member complaints, and pharmacy access.

Plan NameInsurerStar RatingPremiumDeductible
Wellcare Classic (PDP)Wellcare3.5 ★$5.70/mo$615Enroll
Wellcare Value Script (PDP)Wellcare3.5 ★$5.60/mo$615Enroll
Silverscript Choice (PDP)Aetna Medicare3.0 ★$97.40/mo$615Enroll
Humana Basic Rx Plan (PDP)Humana3.0 ★$0.00/mo$615Enroll
Humana Value Rx Plan (PDP)Humana3.0 ★$4.30/mo$601Enroll

Lowest Monthly Premium

Lower premiums help with monthly cash flow, but check drug tier costs and the deductible.

Plan NameInsurerMonthly PremiumDrug DeductibleStar Rating
Humana Basic Rx Plan (PDP)Humana$0.00/mo$6153.0 ★
Humana Value Rx Plan (PDP)Humana$4.30/mo$6013.0 ★
Wellcare Value Script (PDP)Wellcare$5.60/mo$6153.5 ★
Wellcare Classic (PDP)Wellcare$5.70/mo$6153.5 ★
Healthspring Assurance Rx (PDP)Healthspring$32.60/mo$6152.5 ★

Lowest Annual Drug Deductible

The deductible is what you pay out-of-pocket before the plan starts covering drug costs. The 2026 maximum Part D deductible is $590. Many plans offer $0 deductible options.

Plan NameInsurerDrug DeductibleMonthly PremiumStar Rating
Humana Premier Rx Plan (PDP)Humana$0$108.60/mo3.0 ★
Aarp Medicare Rx Preferred From Uhc (PDP)Unitedhealthcare$130$94.50/mo2.0 ★
Humana Value Rx Plan (PDP)Humana$601$4.30/mo3.0 ★
Humana Basic Rx Plan (PDP)Humana$615$0.00/mo3.0 ★
Wellcare Value Script (PDP)Wellcare$615$5.60/mo3.5 ★
Understanding drug tiers: Part D plans organize medications into 5 cost tiers — Tier 1 (Preferred Generic) is cheapest; Tier 5 (Specialty) is most expensive. Two plans with the same premium can have very different costs for your drugs depending on tier placement. Learn more about drug tiers →

Choosing the Right Part D Drug Plan

The right Part D plan depends on your specific medications. Key factors to evaluate:

  • Formulary: Verify your drugs are covered before enrolling
  • Preferred pharmacies: Lower copays at certain locations—check your pharmacy is in-network
  • Total annual cost: Premium + deductible + copays for your drugs

Read our full guide on choosing Part D →
What is a formulary? See our Medicare Glossary →

Part D Drug Plan Insurers in 20742, MD

5 insurance companies offer standalone Part D drug plans in 20742, MD. Below, we group plans by insurer.

Wellcare
Avg Star Rating
3.5 ★
2 plans
From $5.60/mo
Plan
Premium
Deductible
Stars
Type
Wellcare Value Script (PDP)
$5.60/mo
$615
3.5 ★
PDP
Wellcare Classic (PDP)
$5.70/mo
$615
3.5 ★
PDP
Humana
Avg Star Rating
3.0 ★
3 plans
From $0.00/mo
Plan
Premium
Deductible
Stars
Type
Humana Basic Rx Plan (PDP)
$0.00/mo
$615
3.0 ★
PDP
Humana Value Rx Plan (PDP)
$4.30/mo
$601
3.0 ★
PDP
Humana Premier Rx Plan (PDP)
$108.60/mo
$0
3.0 ★
PDP
Aetna Medicare
Avg Star Rating
3.0 ★
1 plans
From $97.40/mo
Plan
Premium
Deductible
Stars
Type
Silverscript Choice (PDP)
$97.40/mo
$615
3.0 ★
PDP
Healthspring
Avg Star Rating
2.5 ★
2 plans
From $32.60/mo
Plan
Premium
Deductible
Stars
Type
Healthspring Assurance Rx (PDP)
$32.60/mo
$615
2.5 ★
PDP
Healthspring Extra Rx (PDP)
$66.60/mo
$615
2.5 ★
PDP
Unitedhealthcare
Avg Star Rating
2.0 ★
2 plans
From $37.80/mo
Plan
Premium
Deductible
Stars
Type
Aarp Medicare Rx Saver From Uhc (PDP)
$37.80/mo
$615
2.0 ★
PDP
Aarp Medicare Rx Preferred From Uhc (PDP)
$94.50/mo
$130
2.0 ★
PDP

Plan availability, premiums, and benefits shown are based on CMS data and may change. Always verify current details with the insurer and at Medicare.gov before enrolling.

Ready to Enroll in 20742, MD?

Compare plans side-by-side at Medicare.gov or speak with a licensed Medicare specialist.

Compare Plans at Medicare.gov Call 1-800-MEDICARE

📋 Print our Medicare Enrollment Checklist — gather your info before you compare.

📅 Enrollment Dates & Deadlines · 🩺 Questions to Ask Your Doctor

Medicare.gov is the official U.S. government site for Medicare. Available 24/7.

Pharmacy Access in 20742, MD

Part D plans have preferred pharmacy networks where you'll pay lower copays. Here's a look at pharmacy options in and around 20742, MD.

Total Pharmacies

98
within 5.0 miles

Chain Pharmacies

47
CVS, Walgreens, etc.

Independent Pharmacies

51
locally owned
PharmacyAddress & PhoneDistanceType
PREMIUM PHARMACY SERVICES INC4701 MELBOURNE PL COLLEGE PARK, MD 207402540📞 301-147-05000.6 miIndependent
MARYLAND CVS PHARMACY LLC8319 BALTIMORE AVE COLLEGE PARK, MD 207402435📞 301-122-38600.6 miChain
STATE OF MARYLAND3983 CAMPUS DRIVE UNIVERSITY OF MARYLAND COLLEGE PARK, MD 207420001📞 301-131-81670.7 miIndependent
MARYLAND CVS PHARMACY, L.L.C.7300 BALTIMORE AVE COLLEGE PARK, MD 207403206📞 301-127-61140.7 miChain
DEMMY'S PHARMACY LLC4900 GREENBELT RD COLLEGE PARK, MD 207402015📞 301-122-31241.1 miIndependent
NAI SATURN EASTERN LLC3702 E WEST HWY HYATTSVILLE, MD 207822004📞 301-195-19431.6 miIndependent
MARYLAND CVS PHARMACY, L.L.C.3605 E WEST HWY HYATTSVILLE, MD 207822006📞 301-127-01991.7 miChain
MARYLAND CVS PHARMACY, L.L.C.5910 GREENBELT RD GREENBELT, MD 207701010📞 301-144-88101.7 miChain
WALGREEN CO9139 RIGGS RD ADELPHI, MD 207831637📞 301-143-32321.7 miChain
GREY PHARMACY LLC6201 GREENBELT RD STE M9 BERWYN HEIGHTS, MD 207402358📞 240-059-30151.8 miIndependent

Pharmacy data from CMS. Network participation varies by plan—always verify with your specific Part D plan.

Local Healthcare Access in 20742, MD

Before choosing a plan, consider the healthcare infrastructure in 20742, MD. Medicare Advantage plans restrict you to in-network hospitals, so understanding local hospital quality helps you pick the right plan — not just the cheapest one.

Note: The facilities below do not indicate which providers are in-network for any specific plan. Always verify network status with your plan before enrolling.

Hospitals Nearby

10
within 25.0 miles

Top-Rated Hospitals near 20742, MD

If hospital access matters to your plan choice, check quality ratings before you enroll. These are the highest CMS-rated hospitals near 20742, MD — click a hospital name to see its full profile and verify it's in your plan's network.

View all 10 hospitals near 20742, MD to check quality before you enroll →

Hospital data from CMS Hospital Compare and Provider of Services file. Distance calculated from center of 20742, MD.

Questions to ask your doctor about Medicare coverage →

Telehealth in 20742, MD: Is Your Internet Ready?

Many Medicare Advantage and some Part D plans now include telehealth benefits, making routine check-ins and prescription refills easier from home. But telehealth requires reliable internet—here's a look at connectivity in 20742, MD. For official guidance on virtual visits, see Telehealth.HHS.gov from the U.S. Department of Health & Human Services.

Internet Coverage in 20742, MD

Fiber Available
65.3%
of households
Cable/DSL Available
80.1%
of households
Top Provider
XFINITY
80.1% coverage
No Broadband
21.8%
of households

Internet coverage data from ISP Reports. View full internet report for 20742, MD.

Medicare-Relevant Demographics in 20742, MD

Understanding 20742, MD's demographics helps contextualize why insurers offer the plans they do. Areas with more seniors and higher incomes tend to attract more insurer competition, while areas with higher Medicaid enrollment may have more Dual-Eligible Special Needs Plans (D-SNP) available.

Total Population
11,365
Population 65+
289
2.5% of total
Median Age
21
17.1 years younger than the national average
Median Income
$30,611
59.3% below the National Average
On Medicare
200
1.8% of residents
On Medicaid
363
3.2% of residents
Uninsured
261
2.3% of residents
Social Security Recipients
908
8.0% of population

Demographic data from U.S. Census Bureau American Community Survey (2023). View full 20742, MD demographics (BestNeighborhood.org).

Local Medicare FAQ: 20742, MD

Common decision points based on 20742, MD's specific plan market and local healthcare landscape.

How does 20742, MD's Medicare Advantage market compare?

20742, MD has 34 Medicare Advantage plans from 8 insurers. This is below the national average of approximately 57 plans. In areas with fewer competing plans, it's especially important to compare the available options carefully. The local mix includes 23 HMO and 11 PPO plans. Plan availability updates annually during the Medicare Annual Enrollment Period (October 15 – December 7).

Should I choose an HMO or PPO Medicare Advantage plan in 20742, MD?

With 10 hospitals within 25.0 miles, 20742, MD has strong provider density. HMO plans (23 available) typically have lower premiums but require referrals and in-network care. PPO plans (11 available) offer more flexibility to see out-of-network providers at higher cost. In 20742, MD, HMO plans dominate the market, which often means more competitive HMO pricing. Always verify your doctors are in-network before enrolling in any plan.

What's the real cost of $0 premium plans in 20742, MD?

27 plans (79% of available options) in 20742, MD charge $0 beyond the standard Part B premium. This high percentage reflects strong insurer competition in the area. However, $0 premium doesn't mean $0 cost. These plans may have higher copays, coinsurance, or out-of-pocket maximums. In 20742, MD, maximum out-of-pocket limits range from $1,000 to an average of $7,346. We recommend calculating your total expected annual cost (premium + copays + drug costs) rather than choosing based on premium alone.

How does the 2026 $2,000 drug cap affect 20742, MD beneficiaries?

The Inflation Reduction Act capped annual out-of-pocket drug spending at $2,000 starting in 2025, eliminating the old "donut hole" coverage gap. This applies to all 10 standalone Part D plans in 20742, MD.

What this means locally:

  • Cost predictability — No matter which of the 10 Part D plans you choose, your drug costs are capped at $2,000/year
  • $0 deductible options — Some local plans offer $0 deductibles, meaning coverage starts immediately
  • Low-income options — 2 plans meet the regional benchmark for Extra Help/LIS eligibility

While the out-of-pocket cap standardizes maximum costs, formulary coverage still varies significantly between plans. A drug that costs $5/month on one plan's formulary might cost $50 on another. Always check that your specific medications are covered and compare tier placement before enrolling.

See all Medicare FAQs in our complete guide → · Enrollment checklist →
Medicare Glossary · Enrollment Dates & Deadlines · Doctor Questions

About the Data & Editorial Team

Wes Ward

Wes Ward

Founder & Data Lead

Wes Ward is the founder of InsuranceDataNow.org and reviews all content for data accuracy and methodology compliance.

With 25+ years in data analytics — including work with highly regulated genomic data at Ancestry.com — Wes brings enterprise-level rigor to consumer data tools. He is also a co-founder of BestNeighborhood.org, CrimeGrade.org, and ISPReports.org.

Role: Reviews and approves all content for data accuracy, source verification, and methodology compliance.

View full profile →LinkedIn

Transparency & Disclosures

InsuranceDataNow is an advertising-supported publisher based in South Jordan, Utah. We are not affiliated with or endorsed by Medicare or the U.S. government.

TPMO Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (24 hours a day/7 days a week) to get information on all of your options.

Sources

All data is sourced from official government databases and trusted third-party providers. Data is updated regularly—see page header for last refresh dates.

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