Premiums for Medicare Drug Plans Will Be Less Next Year, Feds Say

Average monthly premiums for Medicare Part D and Medicare Advantage plans will decrease in 2026, according to the Centers for Medicare & Medicaid Services (CMS).

While benefits and plan choices are expected to be stable next year, Medicare Advantage plans from private insurers project that their enrollment will fall from 34.9 million in 2025 to 34 million in 2026. That’s an expected decline from 50 percent of eligible Medicare beneficiaries to 48 percent.

But as beneficiaries prepare for this year’s Medicare open enrollment, which runs Oct. 15 to Dec. 7, CMS expects that Medicare Advantage enrollment will be “more robust than the plans’ projections and that enrollment will be stable,” the agency said Friday.

While the number of Medicare Advantage plans nationally will fall from 5,633 to about 5,600 in 2026, 99 percent of Medicare beneficiaries will have at least one Medicare Advantage plan operating in their area next year, CMS says. And 97 percent will have a choice among 10 or more Medicare Advantage plans.

Do some comparison shopping during open enrollment

“Millions of Medicare beneficiaries will continue to have access to a broad range of affordable coverage options in 2026,” says Dr. Mehmet Oz, CMS administrator. “We want every beneficiary to take advantage of open enrollment. Compare your options and choose the plan that gives you the right care at the best price.”

The average premium for a stand-alone Part D prescription plan, a private insurer offering for original Medicare beneficiaries, is projected to be $34.50 next year, a decline of $3.81 from 2025 and a projected savings of nearly $46 annually. Your premium could be higher or lower; the average is the middle of the sum of all the plans divided by the number of plans.

The average Part D total premium for Medicare Advantage plans with prescription drug coverage is projected to fall from $13.32 in 2025 to $11.50 in 2026 after Medicare Advantage program rebates are applied. CMS expects the average premium for all types of Medicare Advantage plans to decrease from $16.40 in 2025 to $14 in 2026.

New plan finder features come online Oct. 1

The Medicare.gov website and its Medicare Plan Finder tool can help beneficiaries compare Medicare Advantage and Part D plans. For 2026, the plan finder will include new features that show which Medicare Advantage plans accept beneficiaries’ preferred providers and more detailed information about Medicare Advantage plans’ supplemental benefits.

The plan finder improvements will be available Oct. 1, 2025. In coming months, the Medicare website will include an AI-powered prescription drug cost estimator to compare local pharmacies’ prices.

During open enrollment, consumers can call 1-800-MEDICARE 24 hours a day, seven days a week for help comparing plans and costs. Be aware that wait times on the phone may lengthen during a government shutdown.

Eligible older adults with limited incomes and assets and people with disabilities may qualify for financial assistance with premiums, deductibles, coinsurance and copayments from state Medicare Savings Programs (MSPs).

In addition, the federal Extra Help program also helps qualified low-income individuals pay Part D costs. People enrolled in MSPs automatically qualify for the Extra Help program.

Check your plan’s benefits, premiums, other costs

Even though average premiums aren’t rising, they are increasing for some plans. Part D and Medicare Advantage plans can also make other changes to their coverage and costs, so comparing plans during open enrollment remains important.

Out-of-pocket spending for Part D-covered drugs will be capped at $2,100 in 2026. But plans also can remove medications from their drug lists, add prior authorization restrictions for more medications and even increase deductibles, up to $615, and copayments before you reach the cap.

A monetary incentive that CMS provided stand-alone drug plans to keep enrollees’ monthly bills stable in 2025 will continue in 2026 but has been scaled back. For 2026, CMS will cut a $15 beneficiary premium reduction to $10 and allow stand-alone plans to increase total Part D premiums by up to $50 instead of $35.

Unless you qualify for Extra Help, no Part D plans without a premium will be available. In the past, such plans offered those on original Medicare who took few or no prescriptions the ability have creditable coverage without a monthly cost.

“By reducing the amount of premium stabilization from the government in 2026, we are facilitating the program’s return to operating under regular market conditions,” CMS said in July.

Also look for new limits on coverage

If you have a Medicare Advantage plan, pay attention to coverage for your medical needs and details of other benefits, such as copays and limits on dental care.

Even if you’ve been happy with your Part D or Medicare Advantage plan, review its annual notice of change to find out what will be different in 2025. You should receive this document from your plan by the end of September.

This story, originally published Sept. 27, 2024, was updated to reflect 2026 coverage information and improvements to the Medicare Plan Finder.