CMS has just released information about Medicare Part D plans for 2026, including plan availability and premiums for the coming year. As this year’s Medicare open enrollment period approaches, there’s some good news for Medicare Part D enrollees when it comes to monthly PDP premiums – lower on average, according to CMS – even as the total number of PDPs available drops yet again.
The headline of CMS’s press release emphasized stability in the Part D marketplace, but a quick review of the data shows that the total number of stand-alone drug plans available in 2026 will fall for the third year in a row, as plan sponsors scale back their PDP offerings (for example, Centene is discontinuing one of the 3 Wellcare PDP options; Health Care Service Corporation is discontinuing one of the 3 Cigna PDP options and withdrawing from several PDP regions) or exit the market entirely (as in the case of Elevance’s Anthem PDPs). Overall, there will be fewer PDPs in 2026 than in 2025 – 360 plans nationwide, down from 464 in 2025.
Firm decisions to exit the PDP market or scale back their PDP offerings in recent years have been based on evaluations about the profitability and viability of the stand-alone drug plan market, particularly for insurers with a smaller footprint, accounting for higher costs associated with a redesigned Part D benefit under the Inflation Reduction Act. The law added an out-of-pocket spending cap for Part D enrollees beginning in 2025 and shifted more of the share of high-drug cost enrollees from the federal government to the plans themselves, which increased plan liability overall. In addition, many insurers that offer both PDP and MA-PD plans have stated their interest in focusing resources on more lucrative Medicare Advantage markets.
Somewhat more unexpected than the reduction in plan availability for 2026 are the year-over-year premium changes for PDPs. A comprehensive KFF analysis will follow in the future, but it appears that substantial premium increases for PDPs across the board didn’t materialize, even as the Trump administration scaled back the level of support for additional PDP premium subsidies through the temporary Part D premium stabilization demonstration established by the Biden administration in 2024. For 2026, the federal government is providing participating PDPs with an across-the-board monthly premium subsidy of up to $10 (down from $15 in 2025) and limiting the monthly premium increase for 2026 to $50 (up from $35 in 2025) – revised parameters which, when they were announced, seemed to point in the direction of higher premiums for PDP coverage in 2026.
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