Walmart Will Cover More Than 250 Drugs at No Cost for Eligible Workers, but Retirees on Medicare May Still Face High Bills

Walmart has introduced free prescriptions for hundreds of employees with conditions such as diabetes and asthma, but that no-cost benefit may not follow them into retirement. Once workers leave the company and move to Medicare, the same medicines could become expensive again.

Walmart (NASDAQ:WMT | WMT Price Prediction) said its 2027 health plans will include more than 250 medications at no charge, among them some GLP-1 drugs, insulin and inhalers. For example, a 66-year-old associate with type 2 diabetes and asthma who qualifies for the coverage could pay nothing for those prescriptions while still employed. After retiring and enrolling in Medicare, though, she could end up paying up to the $2,400 Part D out-of-pocket cap in 2027, plus a monthly premium, depending on how her Medicare plan treats those drugs.

Employees who mainly use low-cost generics may notice little change when they switch to Medicare. But those who depend on expensive brand-name medications, especially GLP-1 therapies and inhalers, could see a much larger jump in pharmacy costs.

Walmart’s $0 Tier Applies Only While You Work There

The zero-dollar prescription tier is available to eligible workers and dependents enrolled in qualifying Walmart medical plans. Enrollment for Walmart’s health coverage runs through Nov. 6. The company’s announcement does not extend the benefit to former employees covered by Medicare.

An associate who keeps working after age 65 may be able to remain on Walmart’s medical plan, including the $0 drug tier. If that person later retires, they will need to secure Medicare prescription drug coverage unless they have other creditable insurance. Going 63 days or more without Part D or another creditable drug plan can trigger a late-enrollment penalty. Medicare adds 1% of the national base beneficiary premium for each full month without coverage, which can raise drug plan premiums permanently.

Five Factors Shape a Retiree’s Drug Costs

Under Part D, what a retiree pays depends on both the medications used and the plan selected. Five elements matter most:

• Formulary and tier. Each plan maintains its own covered-drug list. A medication that costs nothing under Walmart’s $0 tier could require substantial copays or coinsurance under Part D, or it may not be covered at all. Spending on noncovered drugs usually does not count toward the $2,400 cap unless an exception is granted.
• Deductible. In 2027, no plan may set a deductible above $700, up from $615 in 2026. Some plans charge no deductible.
• Coinsurance and the cap. After the deductible is met, the standard Part D benefit requires 25% coinsurance until out-of-pocket spending reaches $2,400 in 2027 ($2,100 in 2026). After that, covered drugs cost nothing for the rest of the year.
• Pharmacy choice. The same prescription may cost different amounts at preferred and standard network pharmacies.
• Insulin. Medicare limits covered insulin products to no more than $35 for a one-month supply, and no deductible applies. At that maximum, the annual cost would be $420 per covered insulin product, compared with possibly nothing under Walmart’s new benefit.

Two additional programs can shift the total. Extra Help lowers premiums, deductibles and coinsurance for people with limited income and resources. On the other end, IRMAA adds a Part D surcharge of $14.50 to $91 a month per person in 2026. It applies above $109,000 in income for single filers or $218,000 for joint filers. CMS says about 8% of Part D enrollees pay the surcharge, so most retirees below those thresholds avoid it. Still, every retiree must pay the standard Part B premium of $202.90 a month in 2026, and Walmart’s drug benefit does not reduce that expense.

One Inhaler, Two Very Different Price Tags

Take an inhaler with an illustrative monthly cost of $400. If it is included in Walmart’s $0 tier, the employee pays nothing while enrolled in the company’s qualifying medical plan. Under a 2027 Part D plan with a $700 deductible and 25% coinsurance, however, the annual out-of-pocket cost could climb to $1,725.

Under that example, the patient would pay the full drug cost until meeting the $700 deductible and then 25% of the remaining covered spending. Over 12 months, that adds up to $1,725 for the inhaler alone. If a covered brand-name GLP-1 is added, total spending could hit the $2,400 annual cap. A plan with no deductible or lower cost-sharing could cost less. If the inhaler is not covered, the patient could owe the full price unless the plan grants an exception. Either way, Walmart’s list does not automatically carry over into Medicare.

What to Review Before Coverage Changes Take Effect

Medicare open enrollment ends Monday, December 7, and coverage changes begin January 1. Workers who retire later in 2027 may qualify for a separate enrollment period once employer coverage ends. In either case, comparing Medicare drug costs before leaving Walmart can help avoid an expensive surprise.

1. Match the exact drug, strength and pharmacy. Before retiring, record each medication’s name, dose and form exactly as Walmart covers it. Then enter those details in Medicare Plan Finder with the pharmacy you expect to use, and compare plans by total annual cost, including premiums. A 40mg tablet and an extended-release version may be placed on different tiers.
2. Coordinate the transition date. If you keep working at Walmart after 65 and remain eligible for its medical plan, you may be able to keep the $0 prescription benefit. Before retiring, confirm when employer coverage ends, whether the drug coverage is creditable and when Medicare should begin. A special enrollment period is usually available after losing employer coverage, but timing matters if you want to avoid gaps.
3. Apply for Extra Help if your income is limited. Submit the application through Social Security before selecting a plan. It reduces the deductible and coinsurance that drive the inhaler example above, and the $35 insulin limit still applies.

Walmart’s new prescription benefit could save workers hundreds or even thousands of dollars each year. But those savings may not last after retirement. Comparing Medicare options before leaving the job could determine whether pharmacy visits cost nothing or turn into a much larger annual expense.