Medicare Part D

Two ways to get Medicare drug coverage in Medina: how the structures compare for 2027

In Medina, Ohio, people on Medicare who want help paying for prescriptions have two very different ways to get it. One path keeps Original Medicare and adds a stand-alone Part D drug plan (often called a PDP). The other folds drug coverage into a Medicare Advantage plan, so medical and pharmacy benefits sit under one roof. Both deliver Part D benefits, but the plumbing behind them is not the same — and if you move from one to the other during this fall's Annual Enrollment Period for 2027, several things change at once.

What is the difference between stand-alone Part D and drug coverage inside a Medicare Advantage plan?

A stand-alone Part D plan (PDP) only covers prescription drugs and is designed to sit alongside Original Medicare (Parts A and B). A Medicare Advantage Prescription Drug plan (MAPD) is a single private plan that replaces how you get Parts A and B and adds Part D drug coverage inside the same plan.

In practice, that means a PDP has its own premium, its own formulary and its own pharmacy network, while your doctor visits and hospital stays stay under Original Medicare. With an MAPD, the same insurer handles both sides — the drug list, the provider network and the medical rules all come from one plan. If you also want a Medigap (Medicare Supplement) policy to help with Part A and B cost-sharing, that only pairs with Original Medicare, not with Medicare Advantage.

How many Medicare drug plan options are available in Medina for 2027?

Medina is in Medina County, where plan availability is set at the county level by the Centers for Medicare & Medicaid Services (CMS). Every year CMS publishes a landscape of stand-alone Part D plans and Medicare Advantage plans offered in each county, and the exact counts for 2027 are posted on medicare.gov's Plan Finder.

Because the lineup can shift from year to year — plans enter, leave or change their service areas — the safest way to see what is actually available in Medina County for 2027 is to run your ZIP code through the Plan Finder at medicare.gov during the Annual Enrollment Period.

What are the 2026 Part D rules that apply to both paths?

The Part D program-level rules apply whether your drug coverage comes through a PDP or an MAPD. For 2026, the Part D maximum deductible is $615 and the annual out-of-pocket cap on covered drugs is $2,100. Once you hit the cap, you pay $0 for covered Part D drugs for the rest of the calendar year.

Two other 2026 features are worth knowing. The old coverage gap, or "donut hole," was eliminated in 2025, so Part D now has three phases instead of four. And the Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs across the calendar year in monthly installments instead of paying the full amount at the pharmacy counter. Higher-income beneficiaries also pay an IRMAA surcharge on Part D; for a single filer in 2026, IRMAA begins above $109,000 in income. CMS has not yet published the equivalent 2027 figures.

What actually changes if I switch between the two?

The biggest mechanical change is automatic: if you enroll in a Medicare Advantage plan that includes drug coverage, Medicare will disenroll you from a stand-alone Part D plan. You cannot hold both at once. Moving the other way — from an MAPD back to Original Medicare plus a PDP — means you also need to think about whether you want a Medigap policy, and whether you can get one without medical underwriting at that point.

A few other things typically shift when you switch paths:

• Networks. PDPs use pharmacy networks only. MAPDs use both pharmacy networks and medical provider networks (HMOs, PPOs and so on).
• Formularies. Each plan has its own covered drug list and tier structure, so the same medication can land on a different tier under a new plan.
• Extra benefits. Dental, vision, hearing or over-the-counter allowances live inside Medicare Advantage plans, not inside stand-alone Part D plans.
• Billing. With Original Medicare plus a PDP, you deal with Medicare for medical claims and the drug plan for prescriptions. With an MAPD, one plan handles both.

When can I move between a PDP and a Medicare Advantage drug plan?

The Annual Enrollment Period runs Oct. 15 through Dec. 7, and changes you make take effect Jan. 1, 2027. During AEP you can switch between Original Medicare and Medicare Advantage, add or drop a PDP, or move from one MAPD to another.

If you are already in a Medicare Advantage plan on Jan. 1, you also have the Medicare Advantage Open Enrollment Period from Jan. 1 through March 31. During that window you can make one change — switch to a different Medicare Advantage plan, or drop Medicare Advantage and return to Original Medicare (with or without a stand-alone Part D plan). Special Enrollment Periods can open outside those windows if you move, lose other coverage or qualify for Extra Help.