Medicare’s annual open enrollment period runs from Oct. 15 through Dec. 7, and this year brings a mixed bag for people shopping for prescription drug coverage.
Recent data from KFF (a nonprofit formerly known as the Kaiser Family Foundation) shows that while monthly premiums are dropping for many stand-alone drug plans, beneficiaries will have fewer options to choose from — and some expensive medications will cost significantly more.
Good news: Lower premiums
If you’re enrolled in Original Medicare, aka traditional Medicare, you may have a Part D stand-alone prescription drug plan (PDP) — and you might see your monthly premium decrease in 2026.
According to KFF research, most of the 10 plans offered nationwide in 2025 that will continue on a national or near-national basis next year are reducing premiums in numerous states.
Here’s what’s happening with some of the most popular plans:
- Wellcare Classic: Enrollees will see premium reductions in 47 states and Washington D.C., with monthly costs ranging from $0 to $45.70 depending on location.
- Wellcare Value Script: The nation’s most popular stand-alone drug plan is increasing premiums in 32 states and D.C., but holding steady or decreasing in 18 others, with monthly costs between $0 and $42.40.
- SilverScript Choice: This plan shows the widest variation — some enrollees face the maximum $50 monthly increase while others see reductions, with premiums ranging from $14.70 to $116 across different states.
The stabilization comes partly from a federal demonstration program that provides participating drug plans with monthly premium subsidies of up to $10 and caps monthly premium increases at $50.
Medicare Advantage plans that include drug coverage remain an even better deal for most enrollees, with many charging no premiums for prescription coverage in 2026.
According to KFF, the following stand-alone drug plans will have lower premiums in the most states in 2026:
- AARP Medicare Rx Saver
- HealthSpring Assurance Rx (formerly Cigna Healthcare Assurance Rx)
- Humana Value Rx Plan
- Humana Premier Rx Plan
- Humana Basic Rx Plan
- SilverScript Choice (available in 49 states and D.C. in 2026)
- Wellcare Classic
Bad news: Fewer plans
Medicare Advantage plans are offered by private health insurance companies that are approved by the federal government and include Parts A and B and often drug coverage.
In 2026, there will be fewer Medicare Advantage prescription drug plans available — 32 — down from 34 in 2025, according to reporting by KFF. That’s a drop from the peak of 36 plans in 2024 but still higher than in 2022 and prior years.
Medicare Advantage insurers have been scaling back their drug plan offerings in response to changes in federal payments and unexpected increases in the use of health services that have led to rising costs and falling profits.
The reduction varies significantly by state:
- New Hampshire saw the largest drop with 13 fewer plans.
- Minnesota lost 11 plans after UCare, the state’s second-largest Medicare Advantage insurer, exited the market altogether.
- UnitedHealthcare and Humana also decreased their offerings in Minnesota, particularly in rural counties with lower enrollment.
Despite the overall decline, six states actually saw increases in plan availability, and the average beneficiary still has access to dozens of options in most areas. However, some beneficiaries will find their current plan is no longer available and will need to choose new coverage during open enrollment.
Bad news: Higher costs for orphan drugs
The 2025 tax and budget reconciliation law will increase costs for certain expensive medications in 2026. An expansion of the “orphan drug exclusion” now protects 18 high-cost medications from Medicare’s price negotiation powers.
These drugs — which treat conditions like cancer, blood disorders and multiple sclerosis — represented $17.5 billion in combined Medicare and patient spending in 2023, an 83% jump from 2019.
For patients taking more expensive drugs on the list, out-of-pocket costs under Original Medicare could reach well over $10,000 per year without supplemental coverage.
The changes will cost the federal government an estimated $8.8 billion over the coming decade, eroding nearly 10% of the savings Medicare expected from its drug negotiation program.
See the full list of orphan drugs that could see higher prices in 2026 in our recent reporting: “Retirees, Brace for Medicare Price Hikes on These 18 Drugs.”
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