Medicare Part D 2026: Costs, Changes & Enrollment Guide

If you're looking to understand the Medicare Part D changes for 2026, you're in the right place. Part D covers prescription drug costs and is an essential piece of your Medicare coverage—especially as plan costs and coverage limits continue to evolve.

What's New for Medicare Part D in 2026?

The Centers for Medicare & Medicaid Services (CMS) has updated the standard Part D benefit for 2026.  Here's what's changing:

2026 Part D Deductible

  • $615 maximum deductible (up from $590 in 2025)

Out-of-Pocket Threshold (TrOOP)

  • $2,100 in 2026 (up from $2,000 in 2025)

How Medicare Part D Works in 2026

Medicare Part D includes several stages:

  1. Deductible Stage – You pay 100% of drug costs up to $615.

  2. Initial Coverage – After meeting the deductible, you pay a portion of drug costs (typically 25%) until you hit the coverage limit.

  3. Catastrophic Coverage – Once you’ve spent $2,100 out-of-pocket, your costs drop dramatically. You may pay nothing or a small copay depending on your plan.

    Tips for Choosing a 2026 Part D Plan

    • Compare plans early during Medicare Open Enrollment (Oct 15–Dec 7).

    • Check your current medications against each plan's formulary (covered drug list).

    • Balance the deductible vs. premium: A lower premium may have a higher deductible—and vice versa.

    • Consider bundling with Medicare Advantage (MA-PD) if you're looking for additional benefits beyond drug coverage.

      Need Help Understanding Your 2026 Part D Options?

      At Medicare Planning, we specialize in helping individuals and families find the right Medicare drug coverage at the right cost. Whether you're comparing standalone Part D plans or bundled MA-PD options, we offer:

      • Personalized consultations

      • Plan comparisons in your ZIP code

      • Help applying for Extra Help if you qualify for financial assistance

The 10 Drugs Being Negotiated for 2026

Below is the list of medications whose new, lower Medicare prices will take effect in 2026:

Drug Name Common Use
Januvia Type 2 diabetes
Farxiga Diabetes, heart failure, kidney disease
Jardiance Diabetes, heart failure
Xarelto Blood thinner, stroke prevention
Eliquis Blood thinner, atrial fibrillation
Entresto Heart failure
Imbruvica Blood cancers (e.g., leukemia, lymphoma)
Stelara Psoriasis, Crohn’s disease
Enbrel Rheumatoid arthritis, autoimmune disorders
Fiasp / NovoLog Insulin for diabetes

These drugs were selected based on their high cost to Medicare and frequency of use. Negotiated savings on these medications range from 30% to 79%, depending on the drug.

2026 Medicare Negotiated drugs

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