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Economy

Medicare drug changes are coming next year. How to prepare.

Last updated: October 11, 2025 11:09 pm
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Medicare drug changes are coming next year. How to prepare.
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The Medicare open enrollment period for 2026 is approaching, bringing some unwelcome changes for beneficiaries enrolled in Part D prescription drug plans.

“Next year, these plans will incur higher costs, featuring increased premiums and elevated out-of-pocket deductibles. Additionally, certain plans might stop covering specific medications, or your pharmacy may no longer offer the best prices,” warns Philip Moeller, a Medicare and Social Security authority who writes the Aging in America newsletter, in a chat with Yahoo Finance.

Moeller added, “All individuals with a Part D plan must remain alert.”

Before diving into the negative news, here’s a brief overview of Medicare.

Medicare consists of three parts: Part A, which includes inpatient hospital stays, skilled nursing facility services, and home health and hospice care; Part B, which covers preventive services, outpatient hospital treatments, and medically administered drugs;

and Part D, which pertains to prescription medications that you personally take.

This year, the open enrollment window begins on October 15 and continues through December 7. This is the time for enrollees to adjust their coverage, which will take effect on January 1. You can alternate between Original Medicare and Medicare Advantage, switch Medicare Advantage plans, and modify or change your Part D prescription drug plan, as well as potentially obtain a new Medigap policy.

Currently, 54.8 million out of the 68.8 million Medicare beneficiaries are enrolled in Part D prescription drug plans provided by private insurers, which is where significant changes for 2026 are anticipated.

Last month, beneficiaries received their Annual Notice of Change (ANOC) letter detailing adjustments in their Medicare Part D coverage and costs that will become effective next year. If this letter is lost among your unread mail, now is the perfect time to locate it.

You will be grateful you did.

In 2026, seniors enrolled in Part D plans will see their annual out-of-pocket drug expenses capped at $2,100 for co-pays or coinsurance for prescription medications covered by their plans, aligning with the 2022 Inflation Reduction Act.

While this sounds promising, it’s essential to note that “this cap only applies to drugs that are actually included in a plan,” explained Juliette Cubanski, deputy director of the Medicare policy program at KFF, in her remarks to Yahoo Finance. This signifies that if you’re using a medication not covered by your plan, you’ll be responsible for the full payment.

Watertown, MA - January 12: A man enters a CVS Pharmacy location. (Photo by Suzanne Kreiter/The Boston Globe via Getty Images)

A man enters a CVS Pharmacy location in Watertown, Mass., on Jan. 12. (Suzanne Kreiter/The Boston Globe via Getty Images) · Boston Globe via Getty Images

Moreover, according to Moeller, most plans will implement a deductible in 2026. In 2025, KFF reported that 85% of standalone Part D plans had deductibles, and for 2026, Part D enrollees will face a maximum annual deductible of $615 for their covered medications—increasing from $590 this year).

TAGGED:ComingDrugMedicareprepareYear
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