Part D Drug Coverage, Costs & New Rules (AHIP 2026)

Study cheat sheet

This lesson covers the fundamentals of Medicare Part D, including the two main plan types: standalone prescription drug plans (PDPs) and Medicare Advantage prescription drug plans (MAPDs). It explains eligibility requirements, formulary structure with tiers and protected classes, and the standard benefit phases. The lesson also details cost-sharing rules, pharmacy networks, late enrollment penalties, and drug management tools like step therapy and prior authorization. Additionally, it reviews 2026 changes from the Inflation Reduction Act, such as the elimination of the coverage gap and the Medicare price negotiation program.

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