Medicare Part D Premiums to Rise Sharply in 2026, but Some Plans May Lower Costs

Strategic Insights -

As fall enrollment for Medicare prescription drug coverage begins, some plans are increasing premiums by $50 or more per month, while others are lowering them. Holly Kluck and her husband, Jeff, are shopping for new Part D plans after learning that their premium would rise by over $50 next year, with their annual costs potentially increasing by $2,000 in 2026.

The couple's experience highlights the importance of reviewing Medicare prescription drug coverage during fall enrollment. With price changes varying widely this year, beneficiaries should carefully examine their options to ensure they are not overpaying for their medications. The Inflation Reduction Act of 2022 has imposed a cap on patients' out-of-pocket spending for covered drugs, which will be $2,100 in 2026, helping protect beneficiaries who take pricey drugs for conditions like cancer and multiple sclerosis.

Key Takeaways:

  • The Inflation Reduction Act of 2022 has imposed a cap on patients' out-of-pocket spending for covered drugs, which will be $2,100 in 2026.
  • Participating insurers may raise premiums as much as $50 per month in 2026, while some plans offer reduced premiums.
  • Beneficiaries can choose from as many as six plans with a zero premium, but these plans typically come with the highest allowable deductible ($615 in 2026).
  • Beneficiaries should carefully examine their options to ensure they are not overpaying for their medications.
  • The Medicare Plan Finder tool is adding directories of providers to Advantage listings this year, but listings may be incomplete or contain errors.
  • Beneficiaries should check with their doctors about any plan they consider, as incorrect information may lead to plan changes during the first three months of the new year.
  • Reviewing annual notices and using the Medicare Plan Finder can help beneficiaries navigate the complexities of Medicare Part D.

Statistics:

  • The Inflation Reduction Act of 2022 imposed a cap on patients' out-of-pocket spending for covered drugs, which will be $2,100 in 2026.
  • Participating insurers may raise premiums as much as $50 per month in 2026.
  • The highest allowable deductible for zero-premium plans is $615 in 2026.
  • Beneficiaries may be able to choose from as many as six plans with a zero premium.
  • The Medicare Plan Finder tool will add directories of providers to Advantage listings this year.

Sources:

  • KFF, a health care research nonprofit.
  • Laura Skopec, a senior research associate at the Urban Institute.
  • Juliette Cubanski, deputy director of the program on Medicare policy at KFF.
  • Kylie Stengel, principal at Avalere Health, a research and consulting company.
  • Philip Moeller, an expert on Medicare and the publisher of a Substack newsletter.