Ask the Pharmacist: Changes to Part D Coverage in 2026
October 29, 2025
By: Anna McGhee
Categories: Ask the Pharmacist
Tags: Prescription Drugs, Medications, Part D Coverage, Medicare Part D
Q: Will there be any changes to my prescription drug coverage in 2026?
A: It is possible that there will be changes to your prescription drug coverage in 2026. Your Annual Notice of Change document, which is mailed out to you each year, contains a summary of year-over-year changes. I also encourage members to review the most up to date 2026 formulary to determine if there are any changes in coverage to your prescription drugs. If you are impacted by a 2026 formulary change, you may be receiving more communications from us in the near future containing additional information and next step options.
Q: How can I save money on my prescription drugs?
A: The easiest way is through obtaining generic drugs. The American Medical Association (AMA), which is the largest organization of medical doctors, has stated that generic drugs are perfectly acceptable to use. Most hospitals routinely use generic drugs to treat their patients, as the U.S. Food and Drug Administration (FDA) requires that all drugs be safe and effective.
Generics use the same active ingredients as brand-name drugs and are shown to work the same way to cure, treat, or prevent illness or health conditions. Generic drugs are usually 30–75% less expensive than brand-name drugs. If you are taking high-cost brand-name or generic on Tiers 3, 4, or 5 drugs, please review our formulary with your prescriber for potential lower cost generic alternatives on Tiers 1 or 2.
In all plans currently offered by Mount Carmel MediGold, Tier 1 preferred generic drugs and Tier 2 generic drugs are available at $0 when ordering through our mail order pharmacy, CVS Caremark.
Q: Can you describe the mail order process?
A: Savings may be available to you when using our mail order pharmacy, CVS Caremark. It is a major convenience having your maintenance medications (drugs you need to take daily/routinely) delivered directly to your home. As stated above, for Tier 1 and Tier 2 drugs via mail order, you will realize additional savings as these tiers have a $0 member cost share. To determine if mail order is right for you, first talk with your prescribing provider to learn if your prescriptions can be written for a 90-day supply. Then reach out to CVS Caremark, at 1-866-785-5714 (TTY: 711), option 2, 24 hours a day, 7 days a week.
Our plan also offers the added convenience of automatic refills through CVS Caremark. CVS will keep track of your refill schedules and help ensure your medication arrives on time. And if your prescription is out of refills or expires, CVS will contact your prescriber to help you get a new prescription via the automatic renewal program. Call CVS Caremark at the number above, or go to caremark.com, for additional information and to enroll in these programs.
Q: What do I do if I need extra help in getting my prescriptions?
A: You may qualify for Part D “Extra Help” through Medicare. Our partner, PremiumAssist, provided by Centauri Health Solutions, can assist you in finding out if you qualify for reduced drug plan premiums, deductibles, co-payments, and coinsurance. You can contact PremiumAssist at 1-877-236-4471 (TTY: 711) to see if you qualify. Visit the Centauri Health Solutions website for additional information and answers to frequently asked questions about PremiumAssist.
You also may qualify for manufacturer discounts on brand name drugs through a Pharmaceutical Assistance Program. Visit the official Medicare website for more information and to find a Pharmaceutical Assistance Program for the drugs you take. After accessing the site, you simply enter the drug in question or browse by the drug name, and manufacturer assistance contact information will be provided.
Another way to get assistance is through the State Pharmaceutical Assistance Program (SPAP). Many states and the U.S. Virgin Islands offer help in paying for prescriptions, drug plan premiums, and/or other drug costs. You can use the State Pharmaceutical Assistance Program lookup tool on the official Medicare website for the most up-to-date information on Iowa's SPAP.
