This month, the Center for Medicare Rights, with support from the National Council on Aging, released a new series of videos explaining Medicare benefits and programs. The series is designed to help Medicare patients and the people who help them better understand their coverage options and ways to save money. You can watch these videos on our YouTube channel.
Learn about and participate in Part D
The Medicare Prescription Drug Benefit (Medicare Part D), offered through private insurance companies, covers most outpatient prescription drugs. It can be added to original Medicare coverage as a stand-alone plan or included as a benefit in most Medicare Advantage plans. Those in Medicare Advantage plans without drug coverage (including some private fee-for-service plans and health savings account plans) can also enroll in stand-alone Part D plans.
Part D can be added to original Medicare coverage as a stand-alone plan or included as a benefit in most Medicare Advantage plans.
For most people, the best time to first enroll in Part D is during the Initial Enrollment Period (IEP), as this prevents coverage gaps and avoids late enrollment penalties. If you have trustworthy drug coverage through another federal program or your job, you can delay Part D enrollment without penalty.
A beneficiary can enroll in a Part D plan if they are already enrolled in Part A or Part B and live in that plan's service area. There are several ways to enroll: online through Medicare's plan finder, by phone at 1-800-MEDICARE (1-800-633-4227), or by joining a plan directly through its website or phone number. If you enroll directly with your plan provider, be sure Medicare receives your official enrollment record.
Additionally, you can add or change Part D coverage throughout the year. During the fall open enrollment period (October 15-December 7), you are free to change your Medicare coverage to include a stand-alone plan or a Medicare Advantage Part D plan. If you signed up for a Medicare Advantage plan during the MA open enrollment period (January 1 through March 31), you can switch between MA plans that include prescription drug coverage, or change to Original Medicare, which includes a stand-alone Part D plan. MA Open Enrollment has some specific additional restrictions: You can only make one change during this period, and if your MA plan includes a standalone Part D plan, you cannot change a standalone Part D plan.
Outside of these annual enrollment periods, you may be eligible for special enrollment periods during which you can modify your Part D coverage.
Part D 2026 Update
This year's Medicare Part D situation reflects recent legislation and beneficiary selection trends. By 2026, each state will offer between eight and 12 separate Part D plans, a 22% decrease from 2025. This effect has been offset in recent years by increased availability of Medicare Advantage prescription drug plans, which have grown in line with overall MA enrollment.
This year's Medicare Part D situation reflects recent legislation and beneficiary selection trends.
Certain fees have also been adjusted for 2026. The Part D out-of-pocket cap (the maximum amount of deductibles, coinsurance, and copayments a beneficiary may have to pay in a year) is $2,100. The first 10 drugs negotiated under the Inflation Reduction Act (IRA) of 2022 will be available at lower prices. The list includes drugs to treat serious chronic conditions such as cancer, diabetes, blood clots, heart failure, autoimmune diseases and chronic kidney disease.
Cost negotiations for other drugs are ongoing and prices will take effect in subsequent years. However, last summer's passage of H.R. 1 expanded the exclusions, allowing drugs to be delayed or excluded from Medicare negotiations, thereby reducing the effectiveness of IRA provisions. That means drugs for certain rare diseases will continue to cost beneficiaries and Medicare more. The Center for Medicare Rights continues to advocate for policies that protect Medicare patients’ access to affordable medications.
