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Drug Cost Estimator
The Drug Cost Estimator prices a year of a client's prescriptions on every Medicare Advantage and Part D plan serving a county: each plan's premium plus the estimated drug out-of-pocket under its formulary tiers, deductible and the Part D out-of-pocket cap, all from the CMS public formulary, pricing and landscape files.
It is free for licensed insurance agents. Enter your email and National Producer Number and the tool opens, with nothing to install and no account to create. Every figure is an estimate from public files, not a quote; verify against the plan documents before advising a client.
What you enter
- ZIP code, resolved to a county
- Plan year
- Up to 15 drugs, by name
- Preferred or standard retail pharmacy
What you get
- Monthly and annual premium for every plan in the county
- Estimated annual drug cost and total annual cost per plan
- Which drugs each plan covers, and any prior authorization, step therapy or quantity limits
- Deductible and the month the out-of-pocket cap is reached
- A printable client summary
Free tools for licensed insurance agents. Not for use by Medicare beneficiaries. Data from CMS public files; verify with plan documents before advising a client.
Medicare plans by county · All Agent Tools
What is a Medicare drug cost estimator?
A Medicare drug cost estimator is a tool that adds up what a client would pay in a year for prescriptions on each Medicare Advantage and Part D plan available in a county. The AgencyView Drug Cost Estimator prices a client’s drug list on every such plan in the county, using CMS public plan files rather than carrier marketing material. The estimator shows an estimated annual drug cost for each plan, so an agent can compare a client’s current plan with other plans before Annual Enrollment. Part D plan costs and formularies change every January, which makes a fresh estimate part of each fall plan review. The estimator is free for licensed agents and opens with an email address and a National Producer Number. An estimate is not a quote, and each plan’s own formulary and pharmacy network make the final determination of what a client pays.
Sources: CMS: Medicare Advantage and Part D contract and enrollment data · Medicare.gov: Part D costs