Enrollment
Medicare Part D also called Prescription Drug Plans are also offered by private insurance companies, and you can comparison shop and choose a plan that best suits your needs.
Part D
Medicare Part D is voluntary, meaning you can choose to have a Prescription Drug Plan. But be careful, if you do not enroll into a Prescription Drug Plan or a plan that includes Prescription Drug coverage, you will be penalized by Medicare. Prescription Drug Plans are often coupled with a Medicare Supplement plan to give more of a complete cover for their members. Remember that Medicare Advantage plans include prescription drug coverage. If you do enroll in Part D when you are first eligible, you will be able to access retail prescription drugs at a more affordable rate and enjoy protection against high costs in the event you need a very expensive medication.
Cost
The annual out-of-pocket cap on covered prescription drugs will increase to $2,100 in 2026 (up from $2,000 in 2025).
The “donut hole” or coverage gap is effectively eliminated for most beneficiaries — once you reach your plan’s deductible and move through initial coverage, you progress directly toward meeting the out-of-pocket cap and then into catastrophic coverage.
Deductible maximums are changing: in 2026 no Part D plan may have a deductible higher than $615 (up from $590 in 2025).
The Medicare Prescription Payment Plan (which lets you spread Part D out-of-pocket costs in monthly installments) becomes more streamlined in 2026: automatic re-enrollment unless you opt-out, improved renewal notices, and more defined administrative rules.
The monthly cap on insulin costs continues: for 2026, cost-sharing for covered insulin products remains capped at the lower of: $35 per month, 25% of the negotiated price, or 25% of the maximum fair price established under the drug-price-negotiation program.
Plan premiums may be lower on average in 2026 for many beneficiaries, though the marketplace is shifting and options may be fewer in some areas.
Consideration
These updates to Medicare Part D for 2026 are part of an effort to make prescription drugs more affordable and accessible for all beneficiaries.
How does it work
When you purchase prescriptions at the pharmacy, your Prescription Drug Plan allows for affordable co-pay for your medication. Medications in a Prescription Drug Plan are grouped into tiers that have specific pricing. From your generic drugs to your specialty drugs, your Prescription Drug Plan can offer you coverage. Each time you must purchase a prescription drug in the corresponding tier, you pay the tier co-pay.
Enrollment
You are eligible for Prescription Drug Plans when you first become eligible for Medicare (at age 65). You can consult with one of our Licensed Medicare Agents, who will be happy to explain your plan options, or you can enroll in a Prescription Drug Plan directly through Medicare. Call 1-800-MEDICARE or visit Medicare’s website for enrollment information. If you don’t enroll in Medicare Part D when you are first eligible for Medicare, you can elect a plan later. Each year, during Medicare’s Annual Election Period from October 15 to December 7, you can add, drop, or change your plan selections.
Medicare FAQ's
You are eligible to apply for Medicare during your initial enrollment period which is a 7 month window. 3 months before turning 65, the month you turn 65 and 3 months after turning 65.
The easiest way to sign up for Medicare is online through SSA.gov or by Calling Social Security at 1-800-772-1213. You can also visit your local Social Security Office.
If you are already receiving Social Security benefits you will be automatically enrolled into Original Medicare, otherwise you will be eligible to enroll during your initial enrollment period that starts 3 months before your 65th birthday.
If you miss your Initial Enrollment Period you can sign up during the General Enrollment period that occurs every year January 1st through March 31st. Coverage becomes effective the month following your enrollment date.
Yes, there are penalties for not signing up for Part B of Medicare and will be added to your premium.
If you need a new Medicare card you can order a replacement card by phone at 1-800-772-1213, or online at the Social Security Administration web site. Make sure you have your Medicare number ready when you call.
Medicare has neither endorsed nor reviewed this information. Not connected or affiliated with any United States Government or State agency.
We do not offer every plan available in your area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program
(SHIP) to get information on all of your options.
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