Goodsurance

Drug prices & Part D

Stand-Alone Medicare Drug Plans Now Cost an Average of Four Times More Than Coverage Inside Medicare Advantage

KFF finds the average stand-alone Part D plan runs 36 dollars a month in 2026 versus 8 dollars for drug coverage embedded in Medicare Advantage, a gap driven by rebates unavailable to traditional Medicare enrollees.

By the Goodsurance editorial teamJuly 6, 2026

The average monthly premium for a stand-alone Medicare Part D prescription drug plan is 36 dollars in 2026, more than four times the 8-dollar average for drug coverage embedded in a Medicare Advantage plan, according to a KFF analysis published in June 2026.

The gap stems from a structural difference: Medicare Advantage plans receive rebate payments from CMS that they can redirect to reduce members' costs, including drug coverage premiums. Stand-alone drug plans, which serve people who remain in traditional Medicare, do not receive those rebates. As a result, three-quarters of people in individual Medicare Advantage plans with drug coverage pay no separate drug premium beyond the standard Part B amount, while zero-premium options in the stand-alone market have become rare.

The stand-alone market has also contracted. There are 360 stand-alone drug plans available nationwide in 2026, down from 464 in 2025, as some insurers have exited.

The 2026 annual Part D deductible is 615 dollars. Under the Inflation Reduction Act, the annual out-of-pocket cap on covered drugs is 2,100 dollars in 2026, adjusted from the 2,000-dollar ceiling that first applied in 2025. The cap provides meaningful protection for people with the highest drug costs.

In plain words

If you are on regular Medicare, you need to buy a separate drug plan called Part D. In 2026, those stand-alone plans cost about 36 dollars a month on average. But if you have Medicare Advantage, drug coverage is usually already included in your plan. The average extra cost for drug coverage in Medicare Advantage is just 8 dollars a month. The big difference happens because Medicare Advantage plans get money from Medicare that regular drug plans do not. There are also fewer stand-alone drug plans available in 2026 than there were last year. The most you pay out of pocket for covered drugs in 2026 is 2,100 dollars for the year.

Source: KFF
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