Medicare Part D premiums and costs are rising in 2025 primarily due to structural changes from the Inflation Reduction Act (IRA), which capped beneficiary out-of-pocket drug spending at $2,000. While this benefits patients with high drug costs, it shifts financial risk to insurers, leading to higher premiums. Other factors include reduced government subsidies and rising drug prices.
Researchers said policies prevented premium increases in 2025, but Part D plans may have responded by increasing deductibles or medication cost sharing. The study found mean deductibles for MA plans decreased from $153 in 2019 to $66 in 2024, before sharply increasing to $228 for 2025.
Understanding the 2026 Medicare Part D Price Hike
The prices for many Part D plans are projected to increase due to a combination of new policies, market adjustments, and standard inflation. This means you could see higher monthly premiums and pay more at the pharmacy for your prescription drugs.
Starting in 2025, there is an annual limit on what you pay out-of-pocket for prescription medications through Medicare and Medicare Advantage prescription drug plans. All prescription medications, including specialty medications, covered by Part D plans are included under this cap.
Medicare Part B Premiums/Deductibles: The standard monthly premium for Medicare Part B enrollees will be $185.00 for 2025, an increase of $10.30 from $174.70 in 2024.
Maximum out-of-pocket drug cost
The out-of-pocket maximum for a Medicare Part D prescription drug plan is $2,100 in 2026.
Apply for Medicare Part D Extra Help program. The Extra Help program helps people with limited income and resources lower or cut Part D costs. Medicare Part D provides drug coverage. The Extra Help program helps with the cost of your prescription drugs, like deductibles and copays.
If you have Medicare drug coverage (Part D), your yearly out-of-pocket Part D drugs will be capped at $2,100 in 2026. Once you reach this cap, you won't have to pay a copayment or coinsurance for covered Part D drugs for the rest of the calendar year (page 83).
Best for $0 premiums: Humana Medicare Part D
Humana's $0-premium plans are available in over half of states, and the company offers more $0-copay and $0-deductible options than competitors.
The standard monthly premium for Medicare Part B will be $202.90 a month for 2026, an increase of $17.90 from $185.00 in 2025. The Medicare Part B deductible, or the amount beneficiaries must pay out of pocket before coverage begins, will be $283 in 2026, an increase of $26 from 2025.
Medigap Premium Increases
Attained-Age plans typically experience premium increases as the policyholder gets older, while Issue-Age plans may experience premium increases due to inflation and other factors. Community-Rated plans may also experience premium increases due to inflation, but not due to age.
Starting this year, all Medicare beneficiaries with Part D drug coverage have a $2,000 annual cap on their out-of-pocket medication costs. The cap, part of the 2022 Inflation Reduction Act, is meant to protect Medicare recipients who are not eligible for low-income subsidies from high drug costs.
You can use most GoodRx discounts instead of your Medicare Part D or Advantage plan if the GoodRx price is less than your co-pay. However, you can't combine the two.
UnitedHealthcare gets slightly higher overall star ratings than BCBS and may offer lower prices, but BCBS might offer a better customer experience.
Medicare Part D plans cost an average of $34.50 per month in 2026. $0-premium plans are available in 32 states and Washington, D.C. in 2026. Other Medicare Part D costs to consider are deductibles, copays and coinsurance.
The estimated average enrollment-weighted monthly premium for Medicare Part D stand-alone PDPs is projected to be $45 in 2025, a modest increase from $42 in 2024 (based on June 2024 enrollment).
For the average retired worker, the 2.8 percent COLA is expected to increase their monthly benefit by about $56. This will raise the average payment from approximately $2,008 in 2025 to about $2,064 in 2026. Social Security retirement beneficiaries will see this increase reflected in their January 2026 payments.
Find out about discounts and patient assistance programs. See whether the pharmaceutical company that makes your medicine has a patient assistance program. Some companies offer free or discounted drugs for people who cannot afford them. These companies often require that your doctor contact them first about your case.
Whether you go with the free GoodRx card or a paid plan, GoodRx can help you save hundreds of dollars per year on your out-of-pocket prescription costs. Best of all, this company makes using the card very easy.
Your CalPERS health coverage will automatically be canceled the first day of the month after you turn 65. Review Cancellation of CalPERS Health Coverage for information on reinstating your health coverage.
The IRA introduced significant changes to the Medicare prescription drug benefit as well as the inclusion of price-set medicines starting in 2026. As plans adapt to these changes, it's creating a lot of disruption for patients, many of whom are facing higher premiums, higher out-of-pocket costs and restricted options.
At over $7.3 billion, the most expensive drug covered under Medicare Part D is apixaban, brand name Eliquis, which is used for blood clots. In 2019, nearly 2.2 million Medicare beneficiaries used this drug.
As of 2025, the Medicare Part D “donut hole” no longer exists – meaning there is no longer a coverage gap during which Part D enrollees face higher drug costs. The “donut hole” was eliminated thanks to provisions of the Affordable Care Act (ACA) and the Inflation Reduction Act (IRA).
The most oft-cited reason is that GoodRx further reduces the profits independent pharmacies make through the fees they charge the pharmacy in processing claims. Still, some pharmacies will take GoodRx coupons even though they will lose money, banking on the potential for repeat business from a new customer.