Medicare Part D

Medicare Part D Changes for 2026: What You Need to Know

Medicare is making important updates to Part D, and these changes are designed to make prescription drug costs more affordable and more predictable. Here is a simple overview of what will matter most to you in 2026.

1. A $2,000 Limit on Out of Pocket Costs

Beginning in 2025 and continuing into 2026, Medicare Part D now has a maximum of $2,000 per year for what you pay out of pocket for your covered prescriptions.

Once you reach this limit, you will not pay anything more for your Part D drugs for the rest of the year.

This is one of the biggest improvements Medicare has made for people with ongoing or high medication costs.

2. New Discounts for High Cost Medications

Starting in 2026, Medicare rules require drug companies to give built in discounts on certain expensive medications once you reach the catastrophic phase of coverage.

This helps keep your costs lower and prevents big jumps in your spending later in the year.

3. Lower Prices on Certain Popular Drugs

In 2026, Medicare’s negotiated drug prices begin.

This means Medicare worked directly with drug manufacturers to lower the cost of several commonly used medications, including some diabetes and heart drugs.

If you take one of the medications on the negotiated list, you may notice lower prices when you fill your prescriptions.

4. Insulin and Vaccines Stay Affordable

Two important cost savings are staying in place:

• Insulin costs remain capped at $35 per month
• Vaccines recommended for adults, such as shingles, continue to be covered at no cost

These savings continue in 2026 with no changes.

5. More Stable Monthly Premiums

Medicare is limiting how quickly Part D premiums can increase.

While your plan’s premium may change each year, these rules help prevent large or unexpected increases.

Overall, Medicare Part D is becoming:

• More predictable
• More affordable
• Easier to navigate for people with chronic or high medication needs

If you would like help reviewing your prescriptions or choosing a plan that fits your needs, we are here to help you understand your options.

Enrolling in Medicare Part D

You are eligible for Medicare Part D when you first become eligible for Medicare (at age 65). You can consult with one of our licensed professionals, who will be happy to explain your plan options, or you can enroll in a Part D plan directly through Medicare. Call 1-800-MEDICARE or visit Medicare’s website for enrollment information.

If you opt for a Medicare Part C (Advantage) plan, Part D coverage might already be rolled into that policy.

Since Part D coverage is offered through private insurance companies with plans that vary, you should carefully consider each plan’s formulary to ensure that your preferred drugs will be available through the plan.

If you don’t enroll in Medicare Part D when you are first eligible for Medicare, you can elect a plan later. Each year, during Medicare’s Annual Election Period from October 15 to December 7, you can add, drop, or change your plan selections.