Pharmacy
All McLaren Medicare plans have Part D Prescription Drug coverage built into the plan. Your prescription coverage is included in your premium.
Your costs for a covered drug depend on what coverage phase you are in and what tier your drug is in. Below you will find your plan's coverage information including drug phases, tier copays/coinsurance, and insulin costs.
Part D Prescription Drug Coverage Phases
Deductible Phase:
This is the first payment stage for your drug coverage. The deductible does not apply to covered insulin products and most Part D vaccines.
- If you are enrolled in Inspire you will pay a yearly deductible of $615 on Tier 3, 4 and 5 drugs.
- If you are enrolled in Inspire Plus, you will pay a yearly deductible of $500 on Tier 3, 4 and 5 drugs.
- If you are enrolled in Inspire Select, you will pay a yearly deductible of $615 on Tier 2, 3, 4 and 5 drugs.
Once you pay the applicable Part D deductible for your plan, you leave the Deductible Stage and move to the Initial Coverage Stage.
Initial Coverage Phase:
In this phase, you will pay set copay or coinsurance for covered drugs. Once you reach $2,100, you enter the Catastrophic Coverage Phase.
Catastrophic Coverage Phase:
Once you have moved into the Catastrophic Coverage Phase, you will pay $0 for coverage drugs for the remainder of the year.
2026 Part D Prescription Drug Coverage Tiers (Initial Coverage Phase)
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Tier 1
(Preferred Generic)
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Tier 2
(Generic)
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Tier 3
(Preferred Brand)
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Tier 4
(Non-Preferred Brand)
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Tier 5
(Specialty Drugs)
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Tier 6
(Select Care Drugs)
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Standard Retail Pharmacy
(up to a 30-day supply)
|
$0 copay
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$12 copay
|
25% coinsurance
|
Inspire and Inspire Plus:
40% coinsurance
Inspire Select:
30% coinsurance
|
25% coinsurance
|
$0 copay
|
|
Standard Retail Pharmacy
(90-day supply)
|
$0 copay
|
$36 copay
|
25% coinsurance
|
Inspire and Inspire Plus:
40% coinsurance
Inspire Select:
30% coinsurance
|
not available
|
$0 copay
|
|
Mail-order Pharmacy
(30-day supply)
|
not available
|
not available
|
not available
|
not available
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25% coinsurance
|
not available
|
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Mail-order Pharmacy
(90-day supply)
|
$0 copay
|
$27 copay
|
25% coinsurance
|
Inspire and Inspire Plus:
40% coinsurance
Inspire Select:
30% coinsurance
|
not available
|
$0 copay
|
2026 Part D Insulin Costs
You won’t pay more than $35 for a one-month supply of each insulin product covered under your Part D Prescription Drug benefit, no matter what cost-sharing tier it is on.
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30-Day Supply
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90-Day Supply
(standard retail)
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90-Day Supply
(mail-order)
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Tiers 1 and 6
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$0
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$0
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$0
|
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Tier 2
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$10
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$30
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$23
|
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Tiers 3, 4 and 5
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$35
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$105
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$79
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Other Pharmacy pages:
Drug Price Search
Formulary
Medication Therapy Management
Pharmacy Directory
Pharmacy Utilization Management
Transition Policy