There are a lot of changes to Medicare plans in 2026 so it’s critical to review all the new information before enrolling. Most importantly, don’t assume your plan covers everything it did before.
Fewer Part D plans are being offered in 2026 than in 2025.
Some insurers are pulling or consolidating plans, so you may see fewer options next year. A typical beneficiary will have a choice of between eight to 12 drug plan options in 2026 vs 12 to 16 options in 2026.
Increase on the Part D monthly premium limit and spending cap.
The monthly premium limit will rise from $35 to $50 and the out-of-pocket cap will increase from $2,000 to $2,100. Keep in mind this cap only applies to covered drugs — if a medication isn’t on your plan’s approved list, you’ll still pay full price.
Lower costs on 10 Part D-covered prescription drugs.
Medicare negotiated directly with pharmaceutical companies for the first time ever to get lower prices on 10 popular, high-cost drugs. The negotiated prices will automatically go into effect for those enrolled in Medicare Part D. If you’re not enrolled, consider whether the cost of the premiums now could be worth it in case you need these — or other — drugs in the future. There is a lifetime penalty of 1% for each month you delay Part D coverage without other creditable drug coverage.
The drugs available at lower prices are:
- Eliquis for blood clot prevention and treatment
- Enbrel for rheumatoid arthritis, psoriasis and psoriatic arthritis
- Entresto for heart failure
- Farxiga for diabetes , heart failure and chronic kidney disease
- Fiasp and NovoLog, types of insulin for diabetes
- Imbruvica for blood cancer s
- Januvia for diabetes
- Jardiance for diabetes, heart failure and chronic kidney disease
- Stelara for psoriasis, psoriatic arthritis, Crohn’s disease and ulcerative colitis
- Xarelto for blood clot prevention and treatment
Part B Premiums are expected to increase from $185 to $206.50.
According to the latest Medicare Trustees report, the standard Medicare Part B premium (for doctor visits and outpatient care) is expected to rise from about $185 per month in 2025 to $206.50 in 2026 — one of the largest jumps in program history. The annual deductible is also increasing slightly, which means less net income for those receiving Social Security benefits.
Fewer agents to help you with Plan D.
Many agents no longer receive commissions on Plan D, so fewer will assist with stand-alone Part D drug plans in 2026. For objective help, reach out to your local State Health Insurance Assistance Program (SHIP), a free and unbiased resource.
For additional information on Part D changes, we recommend this blog post from Medicare industry expert and Sunflower’s friend Marcia Mantell.
Medicare Open Enrollment runs until December 7, giving you an opportunity to make changes to your plan.
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