Best Medicare Part D Plans for California Beneficiaries in 2024

We found the 26 best Medicare Part D Plans in California. Sign-up for 2024 Medicare Part D plan notification HERE.

We also ranked the best Medicare Advantage plans with Part D in California for 2024.

California Medicare Part D Plans Have Four Phases

Medicare prescription drug plans are designed to help Medicare beneficiaries pay for their prescription drugs. Some of the cost-sharing concepts of these plans are foreign to new Medicare beneficiaries, so let's look at the four phases.

The Deductible Phase

Prior to a plan paying any of your prescription costs, you are required to pay the annual deductible. So, if you enroll in a 2023 plan with a $400 deductible, you'll spend $400 out-of-pocket before coverage begins. Most Medicare Part D plans have a deductible, but some plans exclude Tier 1 (generics), offering immediate coverage on low-cost medications.

NOTE: $505 is the maximum deductible a plan can have in 2023.

The 2nd Phase is the Initial Coverage Limit (ICL)

For 2023, the Part D Initial Coverage Limit (ICL) is $4,660. Your Part D plan will pay the bulk of your prescription cost during the ICL phase. If your costs exceed $4,660, then you will be in the coverage gap phase (aka "doughnut hole")

The Coverage Gap is the Third Phase

After your gross drug costs have reached $4,660, you will enter the Coverage Gap phase. This is where you will pay 25% of your medication's retail cost. While the price of generic drugs might not be much different, what you pay for brand-name drugs will be higher (because you're paying 25% of the full price). This will continue until you reach $7,400 in True Out Of Pocket Costs (TrOOP).

Some plans offer additional gap coverage, so look for it on the plan information pages.

Phase 4 is Catastrophic Coverage

After you have spent $7,400 in true out-of-pocket costs on your medications, you get out of the coverage gap phase and you automatically receive "catastrophic coverage". In this phase, you will only have to pay a small percentage of coinsurance or payment on covered drugs for the rest of the year.

The out-of-pocket costs that help you get catastrophic coverage include:

1. Your plan's deductible;
2. What you paid during the initial coverage limit period;
3. Most of the full cost of brand-name drugs (and the manufacturer’s discount) purchased in the coverage gap;
4. The amount paid by others, including family members, most charities, and other persons on your behalf; and
5. The amount paid by State Pharmaceutical Assistance Programs (SPAPs), AIDS Drug Assistance Programs, and the Indian Health Service.

Choose Your Part D Plan with Care

Don't make a decision on your choice of Part D Medicare plans based on the premium and deductible alone. It's critical that you verify that your medications are covered. You find this information, and the co-payment tiers, in the formulary. On each PDP page (above) we post links to the formulary and pharmacy web pages, and the phone numbers to contact the plan.

IMPORTANT: Identifying the best Medicare Part D Plans for you takes a bit of research. What's best for you is personal and must consider multiple factors, including your regular prescriptions, your health, and your finances.

Get Your Prescriptions and More with a Medicare Advantage Plan

Medicare realizes that one type of plan does not suit everyone. That's why there are two ways to get help with your prescription drug costs. All of the Medicare prescription drug plans available in California work with Original Medicare. That's one way to get coverage. But maybe you'd like even more benefits. That's where California Medicare Advantage Plans come in. Most offer Part D coverage.

Using Supplemental Medicare Insurance with Part D

Are you thinking about supplemental Medicare insurance that can offer you more coverage? It's a smart move. Original Medicare only covers about 80 percent of your major medical bills, leaving you to cover the rest. We make it easy to find the lowest rates on California Medicare Supplements, also known as Medigap plans. The choice is yours because all Part D plans are compatible with the full range of California Medicare Supplements.

California Medicaid and Your Medicare Part D

California beneficiaries who qualify for both Medicare and Medicaid (aka, "dual eligible" or "Medi-Medi") may be enrolled in a California Medicare Prescription Drug Plan automatically, as well as Social Security's Extra Help program. The Extra Help program pays for most of your prescriptions, but only if you meet the strict eligibility requirements. If the dual eligible option does not meet your needs, you have the option to enroll in a California Part D plan that does. If you are already receiving Medicaid, contact your local Medicaid office for assistance in the transition to Medicare.

Plans Offered

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Centene Corporation, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna-HealthSpring, Humana, Molina Healthcare, Mutual of Omaha, Oscar Health Insurance, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, and UnitedHealthcare.

Citations & References

1. Medicare.gov, "How Medicare Prescription Drug Coverage Works with a Medicare Advantage Plan or Medicare Cost Plan", Last Accessed September 28, 2022
2. Medicare.gov, "What Medicare Part D drug plans cover", Last Accessed August 1, 2022
3. Medicare.gov, "Catastrophic coverage", Last Accessed June 13, 2022
4. Medicare.gov, "Are prescription drugs covered in Medicare Advantage plans?", Last Accessed June 6, 2022
5. SSA.gov, "Extra Help with Medicare Prescription Drug Plan Costs", Last Accessed June 1, 2022
6. CMS.gov, "Landscape Source Files", Last Accessed January 15, 2023
7. CMS.gov, "Medicare Part C & D Performance", Last Accessed January 15, 2023