Our Services
Drug Cost Review
A drug cost review is a free service that matches your full prescription list against the drug coverage in the plans we offer, so your medications land on the most favorable tiers and your total yearly cost is as low as possible. Drug coverage is where Medicare plans differ most, and the lowest premium is rarely the lowest overall cost — so we look at the whole picture, not just the sticker price.
What we review
We check each of your medications against each plan's formulary: whether it's covered, what tier it sits on, the deductible, and how the 2026 Part D out-of-pocket cap of about $2,100 applies. A plan with a cheap premium can be expensive if it puts your key drug on a high tier, so we weigh premium and drug costs together across the plans we offer.
How it works (step by step)
You give us your medications with dosages. We run that list through the plans we offer in your area, compare what each would cost you over a full year, and bring back the option that handles your prescriptions most affordably. If you change medications later, we can re-run the review so your coverage keeps up with your needs.
Who it's for
This is especially valuable for anyone taking regular prescriptions, particularly higher-cost or brand-name drugs, and for people who suspect they're overpaying at the pharmacy counter. It's also worth doing before each Annual Enrollment Period and any time a doctor adds a new medication that could change which plan serves you best.
Why local matters
We help Medicare-eligible residents across the Sioux Falls area and Siouxland, and we know the pharmacies and prescriber patterns here. That local context, combined with reviewing the plans we offer on both sides of the Big Sioux, means your drug coverage is matched to how you actually fill prescriptions close to home.
Questions, answered
Will you check my specific medications against each plan?
Yes. Send us your full list with dosages and we'll run it against the plans we offer, checking coverage, tier, and deductible for every drug. Matching your exact prescriptions to a formulary is one of the most effective ways to lower what you pay over a full year. You can also verify the figures yourself on Medicare.gov.
Why isn't the cheapest premium always the cheapest plan?
Because a low premium can hide high drug costs. If a plan places your medication on a costly tier or applies a big deductible, your total spending can exceed a plan with a higher premium but better drug coverage. We compare premium and drug costs together to find your lowest total cost, rather than letting one eye-catching number drive the choice.
What is the 2026 Part D out-of-pocket cap?
For 2026, Part D includes an annual out-of-pocket limit of roughly $2,100. Once your covered drug spending reaches that point, you pay nothing more for covered drugs the rest of the year — meaningful protection if you take expensive medications, and a factor we weigh in your review. You can confirm the current figure on Medicare.gov.
Does the drug cost review cost anything?
No. The review is free, like our other services, because licensed agents are paid by the carriers. There's no fee to have your prescriptions analyzed against the plans we offer, and you're under no obligation to switch plans after we run the numbers. You simply walk away knowing whether your current coverage is handling your drugs well.
What is the 2026 Part D deductible?
For 2026, the standard Part D deductible is about $615, the amount you may pay for covered drugs before the plan starts sharing costs. Some plans we offer reduce or waive the deductible on certain tiers, so the real figure depends on the plan and your specific medications. We factor the deductible into your total yearly cost. (Verify the current amount on Medicare.gov.)
How can I lower my prescription drug costs on Medicare?
Several levers help: choosing a plan whose formulary covers your drugs at lower tiers, using preferred pharmacies, asking about generic or therapeutic alternatives, and checking whether you qualify for Extra Help. We compare the plans we offer against your full medication list to find the lowest total yearly cost, and we point you toward any assistance programs you may be eligible for.
What are drug tiers and how do they affect my cost?
Part D plans sort covered drugs into tiers — typically from preferred generics up through specialty drugs — and your copay or coinsurance rises with the tier. The same medication can sit on different tiers from one plan to another, which is why two plans can price your prescriptions very differently. We check what tier each of your drugs lands on across the plans we offer.
What happened to the Medicare donut hole?
The old Part D coverage gap known as the donut hole has effectively been eliminated. In its place, Part D now uses a single annual out-of-pocket cap — about $2,100 for 2026 — after which you pay nothing more for covered drugs that year. For people on costly prescriptions, that's a meaningful change. We factor the cap into your review. (Verify current figures on Medicare.gov.)
Can I spread out my drug costs over the year?
Yes. The Medicare Prescription Payment Plan lets you spread your out-of-pocket Part D drug costs across monthly payments instead of paying large amounts at the pharmacy counter all at once. It doesn't lower your total cost, but it can ease the timing, especially early in the year. We can explain how it works and whether opting in makes sense for your situation.
What if my doctor prescribes a new medication mid-year?
Reach out and we'll re-run your drug review. A new prescription can change which plan serves you best, and if the drug isn't covered well on your current plan, you may have options through an exception request or at the next Annual Enrollment Period. Keeping your medication list current is the surest way to keep your coverage matched to what you actually take.