What's new with Part D in 2026
Key changes to Medicare Part D for the 2026 plan year — including cost updates, new drug prices, and program improvements.
The biggest changes for 2026
Out-of-pocket cap rises to $2,100
The annual cap on out-of-pocket prescription drug spending increased from $2,000 in 2025 to $2,100 in 2026. Once you reach this amount in out-of-pocket costs, you pay $0 for covered drugs for the rest of the year. This cap applies to all Part D enrollees, regardless of income.
10 drugs with new Medicare-negotiated prices
For the first time, Medicare has negotiated lower prices on 10 high-cost prescription drugs under the Inflation Reduction Act. These negotiated prices took effect January 1, 2026, and apply to all Part D plans. The drugs treat conditions including diabetes, heart disease, blood clots, arthritis, and cancer.
Estimated savings to beneficiaries: $1.5 billion in 2026.
Medicare Prescription Payment Plan (M3P) auto-enrollment
If you participated in the Medicare Prescription Payment Plan in 2025, you're automatically re-enrolled for 2026 unless you opt out. This plan lets you spread your out-of-pocket drug costs into monthly installments rather than paying them all at the pharmacy. If you switch to a different Part D plan, you'll need to opt in again with your new plan.
Learn more about the Payment Plan →
Deductibles becoming more common
Due to industry-wide trends following the Part D redesign, more plans are incorporating deductibles in 2026. If your plan has a deductible, you'll pay the full cost of certain drugs (typically Tiers 3–5) until you meet the deductible amount. Tiers 1 and 2 drugs (generics) are often exempt from the deductible.
$35 insulin cap continues
The $35 per month cap on insulin costs continues for 2026, with a new calculation: the cap is set at the lower of $35 or 25% of the Maximum Fair Price. You don't need to meet your deductible to get this benefit.
Plan Finder now shows provider networks
The Medicare Plan Finder on Medicare.gov now includes information about which doctors and providers are in a Medicare Advantage plan's network. This was previously only available by visiting individual plan websites.
Review your plan every year
Plans can change their formularies, costs, and pharmacy networks from year to year. During the Annual Open Enrollment period (October 15 – December 7), review your plan's Annual Notice of Change to see if anything affects your medications or costs.
Ready to take the next step?
There are several free ways to get help with your Part D decisions:
You can also visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227)