Medicare Part D
Two paths to Medicare drug coverage in Mount Laurel: what shifts when you change lanes
MOUNT LAUREL, N.J. — If you take a prescription and you're on Medicare, your drug coverage comes through one of two doors. You can pair a stand-alone Part D plan with Original Medicare, or you can pick a Medicare Advantage plan that has drug coverage built in. Both are legitimate paths, but they work differently — and moving from one to the other changes more than just your pharmacy card.
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Will your prescriptions still be covered in 2027?
Part D plans rewrite their drug lists every year — tiers move, pharmacies change, drugs drop off. One call checks your exact medications against the 2027 plans in your area.
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Key takeaways
- Stand-alone Part D works alongside Original Medicare (and often a Medigap policy), while a Medicare Advantage plan with drug coverage bundles medical and drug benefits into one plan.
- Part D has an annual out-of-pocket cap of $2,100 in 2026 and $2,400 in 2027, and a maximum deductible of $615 in 2026 and $700 in 2027. The coverage gap is gone — and these rules apply whether your drug coverage is stand-alone or built into an Advantage plan.
- Switching from an Advantage plan back to Original Medicare plus Part D can affect your ability to buy a Medigap policy at your preferred rate, so check the rules before you make the move.
- The Annual Enrollment Period runs Oct. 15 to Dec. 7; Medicare Advantage Open Enrollment runs Jan. 1 to March 31.
Here's what Mount Laurel residents should understand before switching lanes.
The two structures, side by side
With Original Medicare, Parts A and B cover hospital and medical care. Drug coverage isn't included, so most people add a stand-alone Part D plan from a private insurer. Many also buy a Medigap (Medicare Supplement) policy to help with Original Medicare's out-of-pocket costs. That's three pieces working together.
A Medicare Advantage plan (Part C) is different. A private insurer delivers your Part A and Part B benefits — and, in most Advantage plans, your Part D drug coverage too — all under one plan. You use the plan's network and follow its rules for referrals, prior authorization, and pharmacies.
Mount Laurel is in Burlington County, where residents can choose from a range of both stand-alone Part D plans and Medicare Advantage plans with drug coverage. The exact lineup changes each year.
What stays the same in 2027
The Part D program rules apply no matter which door you walk through:
- The annual out-of-pocket cap for covered drugs is $2,100 in 2026 and $2,400 in 2027.
- The maximum deductible a Part D plan can charge is $615 in 2026 and $700 in 2027 (plans may set it lower).
- The old coverage gap — the "donut hole" — was eliminated in 2025. Part D now has three phases: deductible, initial coverage, and catastrophic.
- The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments instead of paying large amounts at the pharmacy counter.
- Higher-income enrollees pay an IRMAA surcharge on Part B and Part D. In 2026, IRMAA begins above $109,000 in income for a single filer.
These rules follow you across plans. What changes is how the coverage is packaged.
What actually shifts when you switch
Moving between the two structures is more than a paperwork change. A few things to think about:
Your doctors and hospitals. Original Medicare is accepted by most providers nationwide that take Medicare. Medicare Advantage plans use networks — often HMOs or PPOs — and going out of network can cost more or not be covered.
Your drug list. Every Part D plan and every Advantage plan with drug coverage has its own formulary, tiers, and pharmacy network. A medication covered under one plan may sit on a different tier — or not be covered at all — under another. Always check the formulary before you switch.
Extra benefits. Advantage plans may include benefits beyond Original Medicare. Original Medicare doesn't offer those extras, but it does give you broader provider access.
Medigap access. This is the one people miss. If you drop Original Medicare and a Medigap policy to try a Medicare Advantage plan, you may not be able to get the same Medigap policy back later at the same rate. Federal Medigap guaranteed-issue protections are limited, and states can add their own rules. Before you switch, call your Medigap insurer or your local SHIP to understand what you'd face if you wanted to return.
When you can make a change
Two main windows matter:
- Annual Enrollment Period: Oct. 15 – Dec. 7. You can join, switch, or drop a Medicare Advantage plan or a Part D plan. Changes take effect Jan. 1.
- Medicare Advantage Open Enrollment: Jan. 1 – March 31. If you're already in an Advantage plan, you can switch to another Advantage plan once, or return to Original Medicare and pick up a stand-alone Part D plan.
Special Enrollment Periods may also apply if you move, lose other coverage, or your plan leaves the area.
Common mistakes to avoid
- Switching without checking the formulary. Confirm every prescription is covered and note the tier.
- Assuming the pharmacy is in-network. Preferred pharmacy status affects what you pay.
- Forgetting about Medigap timing. If you're leaving Original Medicare for Advantage, learn the rules for coming back before you commit.
- Waiting until Dec. 6. Comparing plans takes time — start earlier in AEP.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in Burlington County
(MA penetration in Burlington County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
Try it
How the 2026 Part D drug cap works
Slide to your estimated yearly prescription costs and see how the new $2,100 out-of-pocket cap protects you. This illustrates the standard Part D benefit; your plan may structure costs differently.
Once your out-of-pocket spending on covered drugs reaches $2,100, you pay nothing more for the rest of 2026. Confirm details at Medicare.gov.
Explore
When can you enroll? An interactive year
Enrollment windows are federal and the same nationwide. Confirm your personal dates at Medicare.gov or 1-800-MEDICARE.
Good to know
Frequently asked questions
Can I have both a Medicare Advantage plan and a stand-alone Part D plan?
Does the $2,100 out-of-pocket cap apply to both types of drug coverage?
If I switch from Advantage to Original Medicare, can I get a Medigap policy?
What is the Medicare Prescription Payment Plan?
- CMS — Medicare Part D program rules (medicare.gov)
- CMS — Medicare basics (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.
Also for Mount Laurel
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This page was last updated: October 6, 2026.