If you’re looking for a Medco Medicare drug plan, the short answer is that Medco no longer exists as a separate company. Express Scripts acquired Medco Health Solutions in April 2012 for roughly $29 billion, and every former Medco Medicare Part D plan is now administered under the Express Scripts Medicare name.1Federal Trade Commission. FTC Closes Eight-Month Investigation of Express Scripts, Inc.’s Proposed Acquisition of Pharmacy Benefits Manager Medco Health Solutions, Inc. If you still have paperwork, a card, or a bookmark that says Medco, the plan behind it is Express Scripts Medicare.
Who Runs the Old Medco Plans Now
Medco Health Solutions was one of the country’s largest pharmacy benefit managers before the merger, handling drug coverage for millions of people, including Medicare beneficiaries. After Express Scripts closed the acquisition in April 2012, former Medco and Express Scripts stockholders became owners of Express Scripts stock, and Medco’s operations were folded into Express Scripts entirely.2U.S. Securities and Exchange Commission. Changes in Business Note 3
Express Scripts itself was then acquired by Cigna in late 2018 and now sits inside Cigna’s health services brand, Evernorth. Despite the layers of ownership, the Medicare drug plans are still marketed directly to beneficiaries as Express Scripts Medicare, and that is the name you will see on current plan materials, bills, and the Medicare Plan Finder.
What That Means If You Had a Medco Plan
You do not need to do anything to “transfer” an old Medco Medicare plan. Any active coverage moved to Express Scripts automatically when the companies merged, and your enrollment history, including the years you were covered, carries over. If you have a plan card showing the Medco name, it has long since been replaced; the issuer, the formulary, and the customer service line all operate under Express Scripts.
If you are not sure whether you are still enrolled, or which Express Scripts Medicare plan you are in, two sources will tell you quickly. The Medicare Plan Finder at Medicare.gov shows your current plan when you log in with your Medicare account. Calling 1-800-MEDICARE (1-800-633-4227) will do the same.
Express Scripts Medicare Part D Today
Express Scripts offers standalone Prescription Drug Plans (PDPs) built to pair with Original Medicare.3Express Scripts. FSBP Open Enrollment These PDPs also work with the Medicare Advantage plans that don’t bundle in drug coverage, such as Private Fee-for-Service and Medical Savings Account plans. Multiple plan tiers are available, with different premiums and cost-sharing, so beneficiaries can choose based on how many prescriptions they fill and how they want to split the cost between premium and pharmacy counter.
Plan names and availability vary by region and change year to year. To see what Express Scripts actually offers where you live, enter your zip code and current medications into the Plan Finder at Medicare.gov; it will show real cost estimates for the coming plan year.
Formulary and Drug Tiers
Every Part D plan has a formulary, which is the list of drugs it covers. Express Scripts organizes its formulary into tiers, and the tier a drug sits on sets what you pay. Lower tiers hold the least expensive generics, with small copays. Higher tiers cover brand-name drugs, non-preferred brands, and specialty medications, where you’ll pay more through either a flat copay or a percentage of the drug’s cost.
If your drug isn’t on the formulary, or sits on a tier with high cost-sharing, you or your doctor can request a formulary exception or a tiering exception. Your doctor submits a statement explaining why the drug is medically necessary, for example because alternatives on the formulary would be less effective or cause side effects. The plan must respond within 72 hours for a standard request and within 24 hours for an expedited one.4Centers for Medicare & Medicaid Services. Exceptions
Three utilization rules can also affect how you fill a prescription:5Medicare. Drug Plan Rules prior authorization, where you need the plan’s approval before filling certain prescriptions; step therapy, where you must try a less expensive drug first; and quantity limits, where the plan caps how much of a drug you can get in a set period. Each of these can be challenged through the same exception process when your doctor believes the restriction isn’t medically appropriate.
Pharmacy Network and Mail Order
Part D plans maintain networks of retail pharmacies, and plans may designate some pharmacies as “preferred,” where copays are lower.6eCFR. 42 CFR 423.120 – Access to Covered Part D Drugs Before filling a prescription, check whether your regular pharmacy is preferred under your Express Scripts plan or whether a nearby preferred location would cost less.
Express Scripts also runs a mail-order pharmacy that delivers a three-month supply of maintenance medications.7Express Scripts. Medicare For drugs you take on a regular schedule, such as blood pressure or cholesterol medications, mail order is often both more convenient and cheaper than monthly retail pickups.
What Your Plan Costs in 2026
Part D coverage in 2026 moves through three phases, and the amounts reset every January 1. This is a significant change from before 2025, when plans had four phases and included a coverage gap known as the donut hole. The donut hole no longer exists.8HealthCare.gov. Donut Hole (Medicare Prescription Drug)
Deductible Phase
You pay the full negotiated cost of your prescriptions until you meet your plan’s annual deductible. No Part D plan can set a deductible higher than $615 in 2026, and many plans set it lower or waive it entirely for certain generic drugs.9Medicare. How Much Does Medicare Drug Coverage Cost?
Initial Coverage Phase
Once the deductible is met, you pay 25% coinsurance on both generic and brand-name drugs, and your plan pays the remaining 75%. This phase continues until your out-of-pocket spending on covered Part D drugs reaches $2,100.9Medicare. How Much Does Medicare Drug Coverage Cost?
Catastrophic Coverage
After you hit the $2,100 out-of-pocket threshold, you enter catastrophic coverage and pay nothing for covered Part D drugs for the rest of the calendar year.10Centers for Medicare & Medicaid Services. Final CY 2026 Part D Redesign Program Instructions Before 2025, catastrophic coverage still required small copays, and the out-of-pocket threshold was much higher.
One point that trips people up: your monthly premium does not count toward the $2,100 cap. Only what you actually spend on covered drugs at the pharmacy or through mail order counts toward reaching catastrophic coverage.11Centers for Medicare & Medicaid Services. Understanding True Out-of-Pocket (TrOOP) Costs
Switching Plans if Express Scripts No Longer Fits
You can join or switch a Part D plan only during certain windows. The main one is the Annual Open Enrollment Period, which runs from October 15 through December 7. Changes made during that window take effect January 1.12Centers for Medicare & Medicaid Services. Understanding Medicare Advantage and Medicare Drug Plan Enrollment Periods
If you are new to Medicare, your Initial Enrollment Period is a seven-month window starting three months before the month you turn 65 and ending three months after it.13Medicare. When Does Medicare Coverage Start? Certain life events, such as moving out of your plan’s service area or losing other drug coverage, trigger a Special Enrollment Period that lets you make changes outside the regular windows.14Medicare. Special Enrollment Periods
To enroll or switch, use the Plan Finder at Medicare.gov, call 1-800-MEDICARE (1-800-633-4227), or contact the Express Scripts Medicare plan directly.15Medicare. Joining a Plan Even if your current coverage started as a Medco plan years ago, reviewing it each fall is worth the effort. Formularies, premiums, pharmacy networks, and tier assignments change annually, and the plan that fit you last year may not be the best match for your current medications in 2026.