With Medicare prescription-drug benefits likely to make major formulary changes in 2026, beneficiaries who hope to minimize their costs at the pharmacy counter need to stay vigilant in the coming months.
What do you need to know for this fall’s Medicare Open Enrollment, which runs from October 15 through December 7?
Medicare prescription-drug benefits are shifting. In 2026, Parts B and D premiums are expected to rise, deductibles will increase, and a $2,100 cap on out-of-pocket prescription-drug costs will go into effect.
There has been little transparency from the Centers for Medicare & Medicaid Services (CMS) about participation in the Medicare Prescription Payment Plan, which is supposed to help beneficiaries who struggle with out-of-pocket costs to spread payments into monthly installments with no interest or fees.
As the next open enrollment period approaches, beneficiaries face complex choices that could save or cost them hundreds of dollars.
Key questions remain: Will CMS assert more authority over Part D plan utilization management practices that limit access to essential drugs? Is the Medicare Prescription Payment Plan helping those who need it most? Will selected medications be available at community pharmacies? How can beneficiaries and advocates shape the next round of negotiations? And how can you ensure you’re getting the most out of your drug plan benefits?
Join The Hill for a timely discussion with Open Enrollment experts, and advocates on the future of Medicare benefits, the impact of drug price negotiations and what beneficiaries need to know for 2026.
The event is scheduled to begin at 8:30 a.m. ET.
