Medicare Part D Plans: What You Need to Know

Medicare patients will have fewer choices when shopping for prescription coverage this fall. The number of available, stand-alone drug plans has been decreasing over the past few years, and this trend is expected to continue for 2026. While most markets will still have several options, some choices are becoming limited, especially for shoppers with low-income subsidies.

Additionally, help may be harder to find because some insurers no longer pay brokers commissions for new business. Shoppers have from October 15 to December 7 to find new coverage that starts in January.

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Who Needs a Medicare Part D Plan

Regular Medicare, which most people qualify for after turning 65, does not come with prescription coverage, known as Part D. People must choose this coverage separately. About 23 million people with regular Medicare have this standalone coverage, according to the non-profit KFF, which studies health care.

Another roughly 34 million people have Medicare Advantage plans, which are privately run versions of Medicare that often come with prescription coverage.

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Changes to Medicare Part D Plans

A typical shopper will be able to choose a standalone drug plan from among eight to 12 options for 2026, according to KFF Medicare expert Juliette Cubanski. This is down from 12 to 16 options in 2025. Shoppers had nearly 30 choices as recently as 2021, according to the Commonwealth Fund’s Gretchen Jacobson.

Depending on the state, a range of one to four plans will be available at no premium to people who qualify for low-income subsidies, according to KFF. Eight were available in 2021. Some insurers are reducing their presence in standalone Part D plans, while the Blue Cross-Blue Shield carrier Elevance is leaving the market entirely.

The Inflation Reduction Act, which will cap annual out-of-pocket drug costs at $2,100 in 2026, puts more financial pressure on insurers. The same law now allows patients to spread the cost of prescriptions over the year.

Medicare Part D Options

Most markets will have several choices. However, experts say Medicare Part D customers don’t like to shop, especially if they already have a plan that covers their medications. Finding affordable coverage for multiple prescriptions can be tricky.

“I think there’s a lot of inertia and, frankly, people may be concerned that if they switch, they’re going to end up worse off,” Cubanski said. More people are being pushed to shop, with nearly 11% of those with standalone prescription drug coverage losing their plan in 2024, according to research published in the Journal of the American Medical Association.

Medicare Part D Prices

Monthly premiums, or coverage prices, will fall nearly 10% on average to $34.50, according to the Centers for Medicare and Medicaid Services. At least one option with a premium of under $20 exists in almost every region of the country, according to the consulting firm Oliver Wyman.

Individual prices will range widely, with premiums for the same plan varying by state, Cubanski noted. While plans may provide lower coverage prices, they could also raise deductibles or offer more limited lists of covered drugs, which are called formularies. Shoppers should check these details.

Getting Help with Medicare Part D Plans

Shoppers can use a federal government website to compare plan prices and coverage. States also have a State Health Insurance Program created specifically to help people on Medicare find coverage. Consumers can help themselves by checking their coverage for changes and comparing it with other plans.

Shoppers should also consider whether their pharmacy is in the network covered by any plan they are considering, said Jacobson, Commonwealth’s vice president of Medicare. Some might also consider switching to Medicare Advantage plans with prescription coverage, but those plans can have more limited networks of covered doctors, which can pose a problem for people with fewer care choices in rural areas.

Why Delaying May Not Be Wise

The enrollment window spans several weeks, but brokers say many people wait until the first week in December to make decisions, often after talking with family during holiday dinners. This can create a deadline crunch that makes it harder to find help in early December.

Conclusion

Medicare Part D plans are changing, and shoppers need to be aware of the options available to them. With fewer choices and potentially higher costs, it’s essential to do your research and compare plans carefully. Don’t wait until the last minute to make a decision, as this can lead to a deadline crunch and make it harder to find help.

Frequently Asked Questions

Q: What is Medicare Part D?

A: Medicare Part D is a prescription drug coverage plan that is available to people with Medicare. It is designed to help cover the cost of prescription medications.

Q: Who is eligible for Medicare Part D?

A: Anyone with Medicare is eligible for Medicare Part D. This includes people who are 65 or older, as well as those with certain disabilities or health conditions.

Q: How do I enroll in a Medicare Part D plan?

A: You can enroll in a Medicare Part D plan during the annual enrollment period, which typically runs from October 15 to December 7. You can also enroll during a special enrollment period if you experience a qualifying event, such as losing your current coverage.

Q: Can I change my Medicare Part D plan?

A: Yes, you can change your Medicare Part D plan during the annual enrollment period or during a special enrollment period. You can also change your plan if you move to a new area or if your plan is no longer available.

Q: How much does Medicare Part D cost?

A: The cost of Medicare Part D varies depending on the plan you choose and your income level. Some plans may have a premium, deductible, and copayment or coinsurance. The average monthly premium for a Medicare Part D plan is around $34.50.