Will my Part D plan automatically keep covering my medications the same way every year?

Not necessarily. Formularies and tier placement can change year to year, so reviewing your plan's Annual Notice of Change against your current prescriptions each fall is recommended.

Does Extra Help guarantee a specific discount amount?

No specific amount can be promised; eligibility and any reduction in costs depend on your individual circumstances, which is why checking your own eligibility is the right next step.

Can I use any pharmacy with any Part D plan in Texas?

Not necessarily at the same cost. Plans contract with specific pharmacy networks and may designate preferred pharmacies, so using an out-of-network or non-preferred pharmacy can affect your costs.

Does RGI Group review Part D plans in person?

RGI Group's one office is in Austin; Part D reviews for Texans statewide are generally done by phone or virtual appointment.

Is comparing Part D plans only necessary when I first enroll?

No, since formularies, tiers, and networks can change yearly, reviewing your Part D coverage during each Annual Enrollment Period is generally a good habit rather than a one-time task.

Medicare Part D prescription drug coverage for Texans

Part D prescription drug coverage is offered through private plans, and each plan has its own formulary, tier structure, and pharmacy network that can change from year to year. For Texans, the plans available and the pharmacies considered in-network depend on where you live, which is why a yearly review of your drug coverage matters regardless of county. RGI Group is a licensed independent Texas insurance agency that helps residents review Part D options by phone or virtual appointment, in English or Spanish. This page explains the general concepts behind formularies, tiers, pharmacy networks, and Extra Help.

What a formulary is

A formulary is the list of prescription drugs a specific Part D plan covers, and each plan designs its own list. Two Part D plans available in the same Texas county can cover different drugs, or cover the same drug differently, so checking your actual prescriptions against a plan's formulary is a necessary step rather than an optional one.

How drug tiers generally work

Formularies generally group covered drugs into tiers, with different cost-sharing depending on the tier a drug falls into. The tier placement of a specific medication can change from one plan year to the next, which is one reason a plan that worked well for your prescriptions this year may look different next year.

Pharmacy networks matter as much as the drug list

Part D plans contract with specific pharmacy networks, and some plans designate certain pharmacies as preferred, which can affect your costs depending on where you fill prescriptions. A pharmacy that is convenient to your home or along your regular travel route in Texas is not automatically in every plan's network or at preferred status.

Extra Help for those who qualify

Extra Help is a program that may lower prescription drug costs for people who qualify based on their individual circumstances. Eligibility and the amount of assistance depend on your situation, so asking whether you might qualify is worthwhile rather than assuming either way.

Why formularies and networks change yearly

Part D plans are permitted to adjust their formulary, tier placement, and pharmacy network each year, and your plan is required to notify you of upcoming changes through its Annual Notice of Change. Reviewing that notice against your current medications each fall is the most reliable way to catch changes before they affect your costs.

A statewide perspective for Texas households

Whether you live in a major metro, a growth suburb, or a rural county, the plans and pharmacy networks offered are specific to your area, so a plan recommendation from someone in another part of Texas may not apply to your situation. Bringing your current drug list and preferred pharmacy to any comparison keeps the review grounded in your own needs.

Questions to ask before choosing a plan

Is each of my current medications on this plan's formulary, and at which tier?
Is my regular pharmacy in this plan's network, and is it considered preferred?
Did my current Part D plan's Annual Notice of Change mention formulary or network changes for 2027?
Might I qualify for Extra Help based on my circumstances?
How does this plan's pharmacy network compare if I travel within Texas or seasonally leave the state?

Frequently asked questions

Will my Part D plan automatically keep covering my medications the same way every year? Not necessarily. Formularies and tier placement can change year to year, so reviewing your plan's Annual Notice of Change against your current prescriptions each fall is recommended.
Does Extra Help guarantee a specific discount amount? No specific amount can be promised; eligibility and any reduction in costs depend on your individual circumstances, which is why checking your own eligibility is the right next step.
Can I use any pharmacy with any Part D plan in Texas? Not necessarily at the same cost. Plans contract with specific pharmacy networks and may designate preferred pharmacies, so using an out-of-network or non-preferred pharmacy can affect your costs.
Does RGI Group review Part D plans in person? RGI Group's one office is in Austin; Part D reviews for Texans statewide are generally done by phone or virtual appointment.
Is comparing Part D plans only necessary when I first enroll? No, since formularies, tiers, and networks can change yearly, reviewing your Part D coverage during each Annual Enrollment Period is generally a good habit rather than a one-time task.

Important notice

Plan availability, benefits, and any Part B premium reduction vary by county, plan, and individual circumstances. The Annual Enrollment Period (Oct 15 – Dec 7, 2026) is different from your Initial Enrollment Period around your 65th birthday.
We do not offer every plan available in your area. We are not affiliated with or endorsed by the U.S. government or the federal Medicare program. Any information we provide is limited to the plans we offer in your area. To find all of your options, contact Medicare.gov, 1-800-MEDICARE, or the Texas Health Information, Counseling and Advocacy Program (HICAP).

Talk with a licensed Texas agent

Call 346-888-0811. Office: 5900 Balcones Drive, Ste 100, Austin, TX 78731. Monday–Sunday, 8:00 AM–11:00 PM. Licensed in Texas. Guidance available in English and Spanish.