Medicare Enrollment: Fewer Choices for Prescription Coverage in 2026
Fewer choices may be on the menu again as Medicare patients shop for prescription coverage this fall. The number of available, stand-alone drug plans has fallen for a few years, and that trend will continue for 2026. Most markets will still have several choices, but some options are becoming particularly sparse for shoppers with low-income subsidies. And help may be harder to find because some insurers no longer pay brokers commissions for new business.
Shoppers have from Oct. 15 to Dec. 7 to find new coverage that starts in January. According to the non-profit KFF, which studies health care, about 23 million people with regular Medicare have standalone coverage, and another roughly 34 million people have Medicare Advantage plans, which are privately run versions of Medicare that often come with prescription coverage.
Who Needs a Medicare Part D Plan?
Regular Medicare, which most people qualify for after turning 65, does not come with prescription coverage, known as Part D. People must choose that separately. A typical shopper will be able to choose a standalone drug plan from among eight to 12 options for 2026, according to KFF Medicare expert Juliette Cubanski. That’s down from 12 to 16 options in 2025.
Shoppers had nearly 30 choices as recently as 2021, according to the Commonwealth Fund’s Gretchen Jacobson. Depending on the state, a range of one to four plans will be available at no premium to people who qualify for low-income subsidies, according to KFF. Eight were available in 2021.
Changes in Medicare Part D Plans
Some insurers are reducing their presence in standalone Part D plans, while the Blue Cross-Blue Shield carrier Elevance is leaving the market entirely. Insurers and analysts who follow the industry note that the Inflation Reduction Act, which will cap annual out-of-pocket drug costs at $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.
Monthly premiums, or coverage prices, will fall nearly 10% on average to $34.50, the Centers for Medicare and Medicaid Services announced last month. At least one option with a premium of under $20 exists in almost every region of the country, according to the consulting firm Oliver Wyman.
Getting Help with Medicare Part D Enrollment
Shoppers can use a federal government website to compare plan prices and coverage. States also have a State Health Insurance Program created specifically to help people on Medicare find coverage. Consumers can help themselves by checking their coverage for changes and comparing it with other plans.
Some might also consider switching to Medicare Advantage plans with prescription coverage. But those plans can have more limited networks of covered doctors, which can pose a problem for people with fewer care choices in rural areas. It’s essential to check the details of each plan, including deductibles and formularies, to ensure the best coverage for individual needs.
For more information on Medicare enrollment and to compare plans, visit Here
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