Medicare Part D SHOCKER: CMS Rejects Plans for 2026! What You Must Know Now

Medicare Part D 2026 Changes: What You Need to Know

For the first time ever, the Centers for Medicare and Medicaid Services (CMS) has rejected bids from standalone Part D plans due to unacceptable year-over-year premium increases. This unprecedented move signals significant Medicare Part D 2026 changes that could impact millions of beneficiaries.

Jae Oh, CFP, author of Maximize Your Medicare, joins Robert Powell to explain how this will create disruption for existing Part D members. If your plan is affected, you could be transitioned automatically or forced to shop for a new Part D plan in 2026. It’s important to note that this decision specifically impacts standalone Part D plans, which operate on annual contracts, and not bundled Medicare Advantage plans.

This isn’t the only major development. Expect higher out-of-pocket costs for Medicare Part D prescriptions, partly driven by rising drug prices, including popular medications like Wegovy. In addition, drug price negotiations for at least 10 drugs under Medicare Part D will begin in 2026, adding more complexity for both patients and providers. The definition of what qualifies as creditable coverage for employer-provided prescription drug plans may also change in 2026, potentially affecting Medicare-eligible employees who still receive coverage through work.

Don’t get caught off guard! If you have a standalone Part D plan, carefully review your Annual Notice of Change (ANOC) letter, which you are guaranteed to receive by federal rule. Starting October 1st, 2025, you can use Medicare.gov’s Plan Finder to compare your options for 2026. The Annual Election Period begins October 15th, giving you the chance to switch or update your coverage.

The year 2026 is shaping up to be one of the most eventful in Medicare history, with a complex tug-of-war between carriers, pharmaceutical companies, and retailers. Staying informed and proactive will be key to protecting your health and your wallet.

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