Enrollment & timing

Part D's First Full Year Under the 2,100-Dollar Spending Cap Shows Premium Dip and Growing Enrollment

A KFF analysis of 2026 Part D data finds stand-alone drug plan premiums fell on average and enrollment rose, but warns the temporary subsidy holding those premiums down is set to expire after this year.

By the Goodsurance editorial teamJuly 11, 2026

The first full year under the redesigned Medicare Part D prescription drug benefit shows an overall picture of premium relief and enrollment growth, according to a June 2026 KFF analysis. Stand-alone prescription drug plan, or PDP, enrollment rose to 24.9 million people in 2026, up from 23.2 million in 2025. Medicare Advantage plans with drug coverage, known as MA-PD plans, cover 31.4 million enrollees, and the Low Income Subsidy program, also called Extra Help, grew to 13.6 million participants.

The average monthly premium for a stand-alone PDP fell from 39 dollars in 2025 to 36 dollars in 2026. Most MA-PD enrollees pay no monthly premium at all; for those who do pay, the average rose modestly from 7 dollars to 8 dollars per month.

The most significant 2026 redesign change is the hard out-of-pocket spending cap set at 2,100 dollars for the year, up from 2,000 dollars in 2025. Once a beneficiary reaches that ceiling, no further cost-sharing applies for covered drugs for the rest of the year.

KFF cautions that the temporary Part D Premium Stabilization Demonstration that helped hold down PDP premiums is scheduled to end after 2026. Stand-alone drug plan enrollees could face steeper premium increases in 2027 when that subsidy expires.

In plain words

In 2026, Medicare's drug coverage went through big changes under the Inflation Reduction Act. One change is a cap on how much you spend on prescription drugs each year. That cap in 2026 is 2,100 dollars. Once you hit that amount, you pay nothing more for covered drugs for the rest of the year. More people joined stand-alone drug plans in 2026, and the average monthly premium dropped from 39 dollars to 36 dollars. The number of people getting low-income drug help also grew. But researchers warn that a government program keeping premiums lower than they would otherwise be ends after 2026. Drug plan premiums could rise more in 2027.

Understand the basics first

Source: KFF
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