Are you ready for the changes coming to Medicare Part D plans?
Summary
Medicare Part D plans for 2026 are now available on Medicare.gov (published 1 October). Expect higher premiums, a reworked coverage structure and a new sixth drug tier. Key changes include a $615 initial deductible, a six-tier initial coverage stage, and an initial out-of-pocket threshold of $2,100 before beneficiaries enter catastrophic coverage, where out-of-pocket costs drop to zero.
Medicare has also negotiated prices for certain high-cost brand drugs — changes that take effect 1 January — and introduced a Medicare prescription payment plan to help spread drug costs across the year. Open enrolment is limited, so beneficiaries should review plans and the Plan Finder on Medicare.gov before the deadline.
Key Points
- 2026 Part D plan details went live on Medicare.gov on 1 October; premiums are increasing.
- Medicare negotiated prices for several high-cost brand-name drugs effective 1 January (examples: Eliquis, Xarelto, Jardiance, Entresto, Stelara and certain insulins).
- Three main coverage stages now govern Part D: deductible, initial coverage (six drug tiers), and catastrophic coverage.
- The initial deductible for 2026 is $615, and the maximum initial coverage out-of-pocket amount is $2,100 before catastrophic coverage begins.
- A new drug tier (tier 6: select care drugs) is being introduced from 1 January.
- Once in catastrophic coverage, beneficiaries pay $0 out-of-pocket for covered prescriptions under both stand-alone Part D and Medicare Advantage plans with Part D.
- The plan year resets on 1 January each year — deductibles and coverage stages start over annually.
- Medicare’s prescription payment plan lets people spread drug costs across the year; details are on Medicare.gov.
- Open enrolment ends on 7 December — use the Plan Finder to compare costs and drug coverage for your medicines.
Why should I read this?
Heads up — if you or someone you care for takes regular medicines, this could hit your wallet and your treatment. Premiums are up and some drugs may no longer be covered on your current plan. Don’t wait: check Medicare.gov’s Plan Finder, compare options and act before 7 December so you’re not left with unexpected costs in January.
Author style
Punchy: this is essential reading for people on Part D. The changes affect premiums, coverage tiers and which drugs are paid for — so if you rely on prescription medication, take this seriously and review your plan now.