Medicare Part D California: Your Guide to Drug Plans in 2025
Choosing the right Medicare Part D plan in California can feel like navigating a maze of premiums, deductibles, and formularies. But it doesn’t have to be overwhelming. With 23 different Medicare Part D California plans available, finding one that fits your healthcare needs and budget is completely possible.
We're here to walk you through everything you need to know so you can make a confident, informed decision about your Medicare Part D California coverage options.
Medicare Part D California: The Complete List
Plan Name | Premium | Deduct. | Benefit | LIS | Gap | Rating |
---|---|---|---|---|---|---|
AARP Medicare Rx Preferred from UHC | $121.60 | $0 | Enhanced | No | No | |
AARP Medicare Rx Saver from UHC | $89.80 | $545 | Basic | No | No | |
AARP Medicare Rx Walgreens from UHC | $80.40 | $410 | Enhanced | No | Yes | |
Anthem Blue Cross MediBlue Rx Plus | $132.70 | $0 | Enhanced | No | No | |
Anthem Blue Cross MediBlue Rx Standard | $100.60 | $545 | Basic | No | No | |
Blue Shield Rx Enhanced | $188.40 | $0 | Enhanced | No | No | |
Blue Shield Rx Plus | $168.90 | $545 | Basic | No | No | |
Cigna Extra Rx | $105.90 | $145 | Enhanced | No | Yes | |
Cigna Saver Rx | $15.80 | $545 | Enhanced | No | No | |
Cigna Secure Rx | $34.50 | $545 | Basic | Yes | No | |
Clear Spring Health Value Rx | $22.70 | $545 | Basic | Yes | No | |
Humana Basic Rx Plan | $75.20 | $545 | Basic | No | No | |
Humana Premier Rx Plan | $129.20 | $0 | Enhanced | No | Yes | |
Humana Walmart Value Rx Plan | $59.00 | $545 | Enhanced | No | Yes | |
Mutual of Omaha Rx Essential | $25.70 | $545 | Enhanced | No | No | |
Mutual of Omaha Rx Plus | $112.30 | $545 | Basic | No | No | |
Mutual of Omaha Rx Premier | $100.30 | $349 | Enhanced | No | No | |
SilverScript Choice | $55.20 | $545 | Basic | No | No | |
SilverScript Plus | $116.00 | $200 | Enhanced | No | Yes | |
SilverScript SmartSaver | $18.60 | $280 | Enhanced | No | No | |
Wellcare Classic | $35.90 | $545 | Basic | Yes | No | |
Wellcare Medicare Rx Value Plus | $82.60 | $0 | Enhanced | No | No | |
Wellcare Value Script | $0.40 | $545 | Enhanced | No | No |
Essential Facts About Medicare Part D California
Medicare Part D California plans are all about helping you afford your prescription medications. It's a separate program from Original Medicare, and private insurers call the shots. But don't worry, the Medicare program sets the rules.
In California, the average Part D deductible this year is $368. But here's the silver lining: 5 plans offer a zero-dollar deductible, which could save you a good amount upfront, depending on your prescriptions.
How Medicare Part D Plans Work
Every Medicare Part D plan covers a wide range of drugs categorized into what’s known as a formulary. Formularies list all the medications covered by that specific plan. Each plan may have different formularies, which is why it’s essential to check and make sure yours includes the prescriptions you need.
Also, every formulary has different “tiers” which categorize medications based on cost. Generally, lower-tier drugs have lower copayments, while higher-tier medications will come with higher out-of-pocket costs.
For example, Tier 1 drugs might include generic medications and have the lowest copayments. Tier 2 might be preferred brand-name drugs and have slightly higher costs. Tiers 3, 4, and 5 might include specialty medications with higher price tags.
Your out-of-pocket costs can vary depending on factors like your chosen plan, the tier level of your medications, and which coverage phase you’re currently in (deductible phase or initial coverage phase, for example).
How to Choose the Right Medicare Part D California Plan
Finding a Medicare Part D California plan that aligns with your individual needs requires careful review of various factors. This ensures that your plan provides the right coverage while minimizing your out-of-pocket costs.
Monthly Premium
The monthly premium is what you pay each month to keep your Medicare Part D plan active, similar to a subscription. While it may be tempting to choose the plan with the lowest premium, it’s crucial to also consider deductibles, copayments, and the extent of coverage.
Lower premiums often come with higher deductibles or more limited coverage, so it's important to find a plan that balances affordable premiums with the coverage you need, helping you avoid surprises later on.
Annual Deductible
The annual deductible is the amount you must pay out of pocket for your prescriptions before your Medicare Part D plan starts contributing.
If you take regular medications, selecting a plan with a lower deductible can save you money over time. However, if you rarely need prescriptions, a higher deductible plan could be more economical.
Drug Formulary
Carefully check the plan’s formulary (list of covered medications) to make sure the drugs you take are on it. Since plans often change their formularies throughout the year, it’s a good practice to review it during the Annual Enrollment Period to confirm your medications are still covered.
Pay special attention to your drug’s tier placement because this directly impacts how much you'll have to pay.
Pharmacy Network
Most plans have preferred pharmacy networks offering reduced medication prices, potentially saving you significant money. Check that the pharmacies you prefer are in the plan’s network and explore if mail-order pharmacy services are an option. This can be particularly beneficial for maintenance medications.
How California Part D Plans Work with Other Parts of Medicare
Medicare Part D offers prescription drug coverage, but how does it work alongside your other Medicare benefits? Let’s break it down for clarity:
Original Medicare (Parts A and B)
With Original Medicare, Part A covers hospital stays, while Part B handles doctor visits and other medical services, including medications administered by your doctor. Part D comes into play by helping cover the costs of the prescription drugs you take at home. Together, these parts provide comprehensive coverage for both medical care and prescriptions.
Medicare Supplement Insurance
Medicare Supplement plans, often referred to as Medigap, help pay for some of the healthcare costs that Original Medicare doesn’t cover, such as copays, coinsurance, and deductibles. However, Medigap plans don’t cover everything.
For example, Medicare Supplements don’t include prescription drug coverage. To get coverage for your medications, you'll need to enroll in a stand-alone Part D plan.
If you take multiple medications, having both a Medicare Supplement plan and a Part D plan can help you manage your costs. Although you’ll pay a monthly premium for each, the added security of comprehensive medical and drug coverage can be well worth it.
Medicare Advantage Plans
If you have a Medicare Advantage plan, also known as Part C, Part D works a little differently. Most Medicare Advantage plans include prescription drug coverage, which means your medical and drug coverage are combined under one plan.
However, some Medicare Advantage plans don’t include drug coverage, allowing you to pair the plan with a separate Part D plan.
Whether you choose Original Medicare with a standalone Part D plan or opt for a Medicare Advantage plan with built-in drug coverage, the key is to find the best fit for your needs. Consider your current prescriptions and budget to help guide your decision, ensuring you have the right coverage for your health.
Important Dates for Medicare Part D Enrollment
Medicare has specific timeframes for enrolling in or modifying your coverage. Here are the key enrollment periods to keep in mind:
- Initial Enrollment Period (IEP): This begins three months before your 65th birthday and lasts for a total of seven months.
- Annual Enrollment Period (AEP): Occurring each year from October 15th to December 7th, this period allows you to make changes to your coverage.
- Medicare Advantage Open Enrollment Period: Held annually from January 1st to March 31st, this period is for those who already have a Medicare Advantage plan.
For more details, be sure to checkout and bookmark our Medicare Enrollment Periods Guide.
Finding Help With Medicare Part D California Enrollment
Finding and comparing Medicare Part D California plans alone can sometimes feel daunting. But there’s help available. Our team of experienced, licensed insurance agents is available by phone (1-877-388-0596) from 8 a.m. to 11 p.m., Monday through Sunday (Eastern Standard Time).
We can answer your questions and assist with plan comparisons to guide you through the process.
Plans Offered Through Medicare.org
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna Healthcare, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, UnitedHealthcare(R), and Wellcare.
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