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There may be fewer options on the menu again as Medicare patients shop for prescription coverage this fall.
The number of available, stand-alone drug plans has been declining for a few years, and this trend will continue through 2026. There will still be plenty of options in most markets, but some options are becoming especially sparse for low-income subsidized buyers. And help may be difficult to find because some insurers no longer pay commissions to brokers for new business.
Buyers have from October 15 to December 7 to find new coverage starting in January.
Some things to consider:
Here’s who needs a Medicare Part D plan
Regular Medicare, which most people qualify for after age 65, does not come with prescription coverage, known as Part D. People will have to choose it separately.
About 23 million people with regular Medicare have this standalone coverage, according to KFF, a nonprofit that studies health care.
Another about 34 million people have Medicare Advantage plans, which are privately run versions of Medicare that often come with prescription coverage.
How Medicare Part D plans are changing
According to KFF Medicare specialist Juliet Cubanski, a typical buyer will be able to choose a standalone drug plan from eight to 12 options by 2026. In 2025, it has reduced from 12 to 16 options.
As recently as 2021, buyers had about 30 options, according to commonwealth Gretchen Jacobson of the Fund.
Depending on the state, a range of one to four plans will be available with no premiums for people who qualify for low-income subsidies, according to KFF. Eight were available in 2021.
Some insurers are reducing their presence in standalone Part D plans, while Blue Cross-Blue Shield carrier Eleven is leaving the market entirely. Insurers and analysts tracking the industry say the Inflation Reduction Act, which would limit annual out-of-pocket drug costs to $2,100 in 2026, puts more financial pressure on insurers. The same law now allows patients to spread the cost of prescriptions over the year.
There are still many Medicare Part D options
Most markets will have multiple options. But experts say Medicare Part D customers don’t like to shop around, especially if they already have a plan that covers their drugs. Finding affordable coverage for many prescriptions can be difficult.
“I think there’s a lot of inertia and, frankly, people may worry that if they switch, they’ll end up worse off,” Cubansky said.
More people are being motivated to buy. About 11% of people with standalone prescription drug coverage may lose their plan in 2024, according to research recently published in the Journal of the American Medical Association.
Before 2023, the figure was often less than 1%, said Dr. Christopher Cai, one of the researchers involved in the study.
Here’s how Medicare Part D prices are changing
The Centers for Medicare and Medicaid Services announced last month that monthly premiums, or coverage prices, would fall by about 10% to $34.50 on average.
According to consulting firm Oliver Wyman, almost every region of the country has at least one option with a premium under $20.
Cubansky said individual prices will vary widely, with premiums for the same plan varying by state.
But while plans may offer lower coverage prices, they may also raise deductible amounts or offer a more limited list of covered drugs, called a formulary. Shopkeepers should check these details.
Insurers will be allowed to raise premiums by $50 a month for 2026, up from the $35 increase allowed this year. But Cubanski said only some plans would reach that high threshold, and not necessarily in all states.
Where to Get Help Shopping for Medicare Part D Plans
Shoppers can use the federal government’s website to compare plan prices and coverage.
States also have a state health insurance program designed specifically to help people on Medicare get coverage.
consumers You can help yourself by checking your coverage for changes and comparing it with other plans.
Jacobson, vice president of Medicare for the Commonwealth, said buyers should also consider whether their pharmacy is in a network covered under any plan they are considering.
Some people may also consider switching to Medicare Advantage plans with prescription coverage. But those plans may have more limited networks of covered doctors, which could pose a problem for people in rural areas with fewer care options.
Why delaying may not be wise
The enrollment window lasts several weeks, but brokers say many people wait until the first week of December to make a decision, often after talking with family during holiday dinners.
This could create a deadline crunch that would make it difficult to get help in early December.
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