Our Services
Drug Cost Review
Drug costs are where Medicare plans differ most. We run your full prescription list against the formulary of every plan we offer in your county to find the one that covers your medications at the lowest tier — often saving hundreds of dollars a year. In 2026 Part D also caps your out-of-pocket drug spending at $2,100.
Why premium is the wrong thing to shop on
Part D plans advertise on premium because it's the simplest number. Your real cost is premium plus deductible plus what your specific drugs cost on that plan's tiers — and the same medication can sit on tier 2 with one plan and tier 4 with another.
What we check for each drug
- Is it on the formulary at all?
- Which tier, and what's the copay or coinsurance?
- Prior authorization, step therapy, or quantity limits?
- Does the deductible apply to that tier?
- Is your pharmacy preferred, standard, or out of network?
The 2026 numbers that shape it
| Item | 2026 |
|---|---|
| Maximum deductible a plan may charge | $615 |
| Out-of-pocket cap | $2,100 |
| Standard coinsurance | 25% |
From the CMS CY2026 Part D redesign instructions; see also Medicare.gov.
Help paying, if it's still too much
Extra Help removes the Part D premium and deductible and caps copays — apply free at Social Security. A Medicare Savings Program pays your Part B premium and automatically qualifies you for Extra Help. New Mexicans apply via the NM Health Care Authority.
Spreading the cost across the year
If a large refill early in the year is the problem rather than the annual total, the Medicare Prescription Payment Plan lets you pay in monthly instalments instead of at the counter. It doesn't reduce what you owe — it changes when you pay it.
We redo this every autumn
Formularies change every January, so we re-run your list each year during October 15 – December 7.
Not sure which of these fits you? A free 15-minute call with a licensed local advisor sorts it out — no pressure, and no cost to you. We do not offer every plan available in your area. For a complete list of every plan in your county, use Medicare Plan Compare or call 1-800-MEDICARE.
What to send us
Send a photograph of your prescription bottles or a printed list from your pharmacy. We need:
- The drug name, dose, and how often you take it.
- Whether it's brand or generic, and whether a generic exists.
- Your pharmacy, and whether you'd use mail order.
- Your ZIP code.
Include the ones you take occasionally too — an expensive as-needed medication can decide the comparison. We'll come back with the projected annual cost on each plan we offer, not just the premium, so you can see the difference in total money rather than in monthly headline.
What the review will not do
We compare the plans we offer in your county, not every plan in existence, and we say so plainly. We also don't make clinical decisions — whether a therapeutic alternative is appropriate is between you and your prescriber, and we never suggest changing a medication for cost reasons alone.
What the review does is put an accurate annual number against each option, so that when you and your doctor do discuss alternatives, the financial side of the conversation is based on real figures rather than guesses.
Questions, answered
Will you check my specific medications?
Yes — send us your list with doses and we'll find the plan among those we offer that covers them at the lowest total cost. It's the single biggest way to save on Medicare.
What if a drug isn't covered anywhere?
We look at therapeutic alternatives with your doctor, a formulary exception request, or manufacturer assistance programmes. There's usually a route.
Does the $2,100 cap mean I'll never pay more?
It caps your out-of-pocket spending on covered drugs at $2,100 for the calendar year — it resets each January 1, and drugs not on your plan's formulary don't count toward it.
Sources
- CMS — Final CY2026 Part D Redesign Program Instructions
- Medicare.gov — Part D costs
- Medicare.gov — Help with drug costs (Extra Help)
- SSA — Extra Help with Medicare drug costs
- Medicare.gov — Medicare Savings Programs
- New Mexico Health Care Authority
Figures are current-plan-year and come from the official sources above. Plan-specific costs vary by county and carrier — confirm yours on Medicare Plan Compare or with a licensed agent.
Content reviewed by Brian Penner, Independent Medicare advisor — no pressure.