Part D in 2026: What Changed, What It Costs, and How to Shop It
Part D spent a decade as Medicare’s most confusing product, and the 2025–2026 redesign finally simplified its core: the coverage gap is gone, a hard out-of-pocket cap protects every enrollee, and manufacturer discounts count toward it. Here is the 2026 landscape and the shopping method that fits it.
The 2026 cost structure
Three numbers define the year: a maximum deductible of $615; the out-of-pocket cap at $2,000 (indexed upward from 2025’s figure); and $0 cost-sharing once the cap is reached — the catastrophic phase now costs members nothing. Manufacturer discounts on branded drugs count toward the cap, which pulls the real-world ceiling down further for anyone on expensive brands.
| Phase | 2026 | Your cost |
|---|---|---|
| Deductible (max) | $615 | Full price until met (many plans have none) |
| Initial coverage | After deductible | Tier copays or ~25% coinsurance |
| After $2,000 cap | Automatic | $0 for covered drugs through Dec 31 |
What did not change
The late-enrollment penalty still accrues at 1% of the national base premium per uncovered month, forever. IRMAA surcharges still key off income from two years prior. Formularies still churn every January. And the Oct 15–December 7 re-shop window is still the only routine annual chance to switch. The redesign fixed the gap; it did not fix the annual churn.
The 2026 shopping method
One: load your exact drug list (doses matter for quantity limits) into Medicare.gov’s Plan Finder. Two: price against your preferred pharmacy — tier copays vary by pharmacy tier network and the reshuffle is real. Three: compare total annual cost: premium + deductible + expected copays. The cheapest-premium plan wins that comparison far less often than people assume. Four: flag any prior-authorization or step-therapy requirements on your drugs before January, because mid-year plan changes are barred. Five: re-run the entire exercise every fall; last year’s winner is this year’s loser more often than chance would suggest.
The coordination with Medigap
No Medigap letter covers prescriptions — Part D is always separate. The standard pairing is a Medigap letter for medical gaps plus a Part D plan for drugs, re-shopped independently each fall. If you are on Medicare Advantage, drugs are usually bundled and the Plan Finder prices MA-PD plans in the same run. Either way, the drug decision is worth an hour a year: it routinely swings $500–1,500 of annual cost.
Related: Part D 2026 mechanics, phases explained, IRMAA surcharge bands.