3. Part D Out-of-Pocket Cap Increases to $2,100
The annual out-of-pocket spending cap for Medicare Part D prescription drug coverage will increase to $2,100 in 2026, up from $2,000 in 2025. While this represents a $100 increase, it still provides crucial financial protection for beneficiaries with expensive medication needs.
Once beneficiaries reach the $2,100 threshold in out-of-pocket costs for covered prescription drugs, they will pay nothing for the remainder of the calendar year. This cap applies to all medications covered under their Part D plan, protecting patients from catastrophic drug costs that could otherwise total tens of thousands of dollars annually.
The Part D deductible will also increase to $615 in 2026, up from $590 in 2025. However, not all plans require beneficiaries to pay the full deductible—many Part D plans offer lower deductibles or no deductible at all. Beneficiaries should carefully review their plan options during open enrollment to find coverage that best matches their medication needs and budget.
Average premiums for stand-alone Part D prescription drug plans are projected to decrease to $34.50 per month in 2026, down from $38.31 in 2025, according to CMS data.
This decrease is partly due to the continuation of the federal premium stabilization program, which provides subsidies to participating insurers. Nearly all Part D enrollees are in plans that have opted into this program for 2026.
The Medicare Prescription Payment Plan, introduced in 2025, continues in 2026 with automatic reenrollment for participants.
This program allows beneficiaries to spread their out-of-pocket drug costs evenly over 12 monthly installments rather than paying large amounts upfront at the pharmacy. For example, someone expecting $2,100 in annual drug costs could opt to pay approximately $175 per month instead.
