How to Review a Parent's Part D Plan Without a Broker or Counselor

If your parent's Annual Notice of Change just arrived, the December 7 enrollment deadline is approaching, and the nearest SHIP counselor appointment is three weeks out — you can do the annual Part D review yourself. The process has seven steps, takes about 90 minutes for a returning review (longer for a first-time enrollment), and requires no insurance expertise. What it does require is legal authority to access your parent's plan details and a current medication list.

This walkthrough covers the full DIY review. For the complete system — including fillable worksheets, appeals templates, and the Extra Help eligibility screener — the Medicare Part D: How to Choose a Drug Plan guide covers everything in one place.

Before You Start: Legal Authority

The single most common point where caregivers get stuck isn't the plan comparison — it's discovering that they can't access their parent's Medicare account or call the plan on their behalf.

A standard Power of Attorney does not work with Medicare. The agency requires Form CMS-1696 (Appointment of Representative), signed by both the beneficiary and the caregiver, filed with each plan or Medicare contractor. If your parent receives Social Security, you also need Form SSA-1696 filed with the Social Security Administration.

Without CMS-1696 on file, you can still run the Plan Finder as a general search (without logging into your parent's account), but you won't be able to call the plan to verify formulary details, file appeals, or confirm enrollment.

If you don't have these forms filed and the enrollment deadline is approaching, file CMS-1696 now — it processes in 1–2 weeks — and use the general search method on the Plan Finder in the meantime.

Step 1: Read the Annual Notice of Change

Every Part D plan mails an Annual Notice of Change (ANOC) by September 30. This document lists every change taking effect January 1: premium increases, formulary drops, tier changes, pharmacy network removals, new prior authorization requirements, and copay structure adjustments.

Go through it with your parent's current medication list in hand. Flag any drug that's been moved to a higher tier, added a restriction (prior authorization, step therapy, quantity limit), or been removed from the formulary entirely. If even one of your parent's medications is affected, a plan switch is worth evaluating.

If the ANOC shows no changes that affect your parent's medications, you still want to verify that the current plan remains the lowest total annual cost — premiums creep up even when formulary coverage stays the same.

Step 2: Build an Accurate Drug List

Pull every prescription bottle from your parent's medicine cabinet. For each medication, record:

• Exact drug name (brand or generic — use what's on the label)
• Strength (e.g., 10mg, 25mg, 100mg/5mL)
• Form (tablet, capsule, extended-release, liquid, cream, injection)
• Quantity per fill (e.g., 30 tablets, 90 capsules)
• Fill frequency (30-day or 90-day supply)

Don't include over-the-counter medications, vitamins, or supplements — Part D doesn't cover them and entering them into the Plan Finder skews the results.

If your parent can't or won't share their medication details, this is where CMS-1696 authority becomes essential. With it filed, you can call the current plan and request a complete medication history.

Step 3: Screen for Extra Help Before Comparing Plans

This step gets skipped by almost everyone — including brokers — and it changes everything about which plan is optimal.

The federal Extra Help program (Low-Income Subsidy) can subsidize Part D premiums, reduce or eliminate deductibles, and cap copays at the applicable assistance level, including $5.10 for generics and $12.65 for brand-name drugs in 2026. For 2026, eligibility thresholds are:

• Individual: Income below $2,015/month ($23,940/year), countable assets below $18,090
• Married couple: Income below $2,725/month ($32,460/year), countable assets below $36,100

Countable assets exclude the primary home, one vehicle, household goods, and life insurance. More than 2 million eligible beneficiaries aren't enrolled.

If your parent qualifies (or is close), apply through Social Security before choosing a plan. Extra Help recipients are auto-assigned to a low-cost benchmark plan, and they can switch plans once per quarter during the first nine months of the year — far more flexibility than standard enrollees get.

One caution for public-sector retirees: the Social Security Fairness Act repealed the GPO and WEP, which may have increased your parent's Social Security income. Retroactive lump-sum payments are excluded from countable assets for only nine months after receipt. If your parent received a retroactive adjustment, verify the timing before assuming they're over the asset limit.

Step 4: Run the Plan Finder Comparison

Go to Medicare.gov and start a plan search. You can do a general search by ZIP code (no login required) or a personalized search using your parent's Medicare account (shows their current plan's data pre-populated).

Enter every medication from Step 2. When the Plan Finder suggests a generic equivalent, select it unless the doctor has specifically required "Dispense as Written." Save the Drug List ID and Password Date — these let you return to the same comparison without re-entering everything.

Select your parent's preferred pharmacy plus at least one alternative. The Plan Finder calculates costs at each pharmacy location, and the difference between preferred and standard network pricing can reach $129/year or more.

Sort results by Lowest Estimated Total Annual Drug Cost + Premium — not by premium alone. A plan with a $0 premium but higher copays can cost hundreds more per year than a plan with a $30 monthly premium and lower cost-sharing on the drugs your parent actually takes.

Step 5: Check Formulary Restrictions on Every Drug

This is the step most people skip. The Plan Finder flags restrictions, but the flags are easy to miss in the results table.

For each of your parent's medications on the top 2–3 plans, check for:

• Prior Authorization (PA): The plan requires the doctor to submit clinical justification before the pharmacy will fill the prescription. Standard turnaround is 72 hours; expedited is 24 hours for urgent medications.
• Step Therapy (ST): The plan requires your parent to try a cheaper alternative first and fail before covering the requested drug.
• Quantity Limits (QL): The plan caps how many doses are covered per fill period.

A plan with one fewer restriction on a critical medication is worth a higher premium. Prior authorization delays can leave a parent without medication for days — especially after a hospital discharge when new drugs are prescribed urgently.

Step 6: Enroll in the New Plan

If a different plan beats the current one on total annual cost with equal or fewer formulary restrictions, switch during the Annual Enrollment Period (October 15–December 7). New coverage starts January 1.

Enroll directly through the Plan Finder, call the new plan, or call 1-800-MEDICARE. Print and save the confirmation number.

Also consider the Medicare Prescription Payment Plan (M3P), which lets your parent spread out-of-pocket costs across monthly installments instead of paying up to $2,100 in the first months of the year. Enrollment is available at any time — the plan processes opt-in requests within 24 hours.

Step 7: Set Up Next Year's Review

Mark your calendar for October 1 — the day after ANOCs arrive. The entire review takes about 60–90 minutes once you've done it the first time. The December 7 deadline doesn't change. Building this into an annual routine prevents the last-minute scrambles that force families into whatever plan a broker suggests.

When to Escalate

Do the review yourself if your parent takes 1–7 medications, doesn't have complex income situations, and the ANOC shows manageable changes. Escalate to professional help if:

• Your parent has 10+ medications with multiple formulary restrictions and you can't determine total cost reliably
• You need to file an appeal for a denied drug and the situation is medically urgent
• Your parent may qualify for Medicaid dual-eligible status, which involves state-specific coordination beyond Part D
• You're dealing with legal incapacity issues that require more than CMS-1696

For the structured version of this workflow — with fillable worksheets, Extra Help screening, appeals templates, and the M3P payment calculator — the Medicare Part D: How to Choose a Drug Plan guide walks you through every step.

Frequently Asked Questions

Can I do the Plan Finder comparison without my parent's login?

Yes. Use the general search option — enter your parent's ZIP code, drug list, and pharmacy manually. You won't see their current plan pre-populated, but you'll get the same comparison results. The personalized search (with login) adds convenience but isn't required.

What if I find a better plan but the enrollment period has closed?

Outside the AEP (October 15–December 7), you can only switch plans during a Special Enrollment Period triggered by specific life events — losing other coverage, moving to a new service area, entering a long-term care facility, or changes in Extra Help status. If none of these apply, your parent stays on the current plan until the next AEP.

How do I know if a broker's recommendation is good?

Run the same drug list through the Plan Finder yourself. If the broker's recommended plan matches the lowest total annual cost option in your comparison — and doesn't have more formulary restrictions than alternatives — the recommendation is solid. If it doesn't match, ask the broker why. They may be recommending a plan from a carrier they have a commission relationship with that isn't the cheapest option.

What happens if I pick the wrong plan?

During the Open Enrollment Period (January 1–March 31), Medicare Advantage enrollees can switch to a different MA plan or return to Original Medicare + standalone Part D. Standalone Part D enrollees don't get this extra window — the AEP (October 15–December 7) is the primary switching opportunity unless a Special Enrollment Period applies. This is why the annual review matters: the wrong choice locks in for a full year.

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