How Medicare Part D will change in 2026

What changes are coming to Medicare Part D in 2026?

With 45 years of experience you can count on, we understand that Medicare coverage is personal and changes to your coverage can affect your life. That’s why UnitedHealthcare wants you to be aware of industry-wide changes to Medicare Part D prescription drug coverage in 2026. Even as regulations impact the entire Medicare industry again this year, you can count on UnitedHealthcare to provide reliable Medicare Advantage coverage and support every step of the way.

Maximum out-of-pocket drug cost

The out-of-pocket maximum for a Medicare Part D prescription drug plan was $2,000 in 2025. That amount will increase to $2,100 in 2026.

Part D prescription drug deductible

The Part D prescription drug deductible is set by the federal government. In 2025 the amount is $590. In 2026 it will increase to $615.

What to know about
Medicare Part D prescription drug deductibles in 2026

Video transcript

Your Medicare prescription drug costs may be changing in 2026. Here’s what you need to know. Due to industry-wide trends in Medicare drug coverage, deductibles are becoming more common in Medicare Part D plans.

What is a Medicare Part D prescription drug deductible? Let’s discuss. A deductible is the amount that you or others on your behalf pay toward your Medicare Part D prescription drugs before Medicare or other insurance starts to pay. The deductible only needs to be met once per plan year and may only apply to certain prescription drug tiers.

Let’s walk through an example with a Tier 3 drug. Let’s say your plan has a prescription drug deductible of $400 for drugs in Tiers 3, 4, and 5, and 20% coinsurance for Tier 3 drugs. Then, let’s say you need to fill your Tier 3 drug that costs $600.

Your first prescription fill of the year could look something like this: Because your drug cost is higher than the deductible, you’ll owe the full $400 deductible amount. At this point, there’s a $200 drug cost remaining.

Once you reach the deductible amount, you’ll enter the Initial Coverage stage. In this stage, you’ll begin to pay your plan’s cost-shares, including copays and coinsurance. Of the $200 remaining drug cost, you’ll pay 20% coinsurance, which is $40. Your plan will pay the remaining $160. This means you’ll owe $440 for your Tier 3 drug.

Now, let’s review what your second prescription drug fill of the year could look like. Because your deductible has already been met, you’re still in the Initial Coverage stage. So, with a $600 drug, your coinsurance payment will be $120 (20% of $600 is $120). The plan pays the remaining cost of $480.

You’ll remain in the Initial Coverage stage until you reach the plan’s out-of-pocket maximum. At this point, you’ll pay $0 for covered Part D drugs for the remainder of the year. If you have a deductible, this amount can be found in your Evidence of Coverage document. Keep in mind, deductible amounts can change each year. It’s important to review your Annual Notice of Changes, sent in September, to know what to expect in the next plan year.

You can count on UnitedHealthcare to provide you with reliable Medicare information and support every step of the way. For more information on Medicare Part D, visit uhc.com/medicare.

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Find the right Medicare plan for all your plans

Here's what you need to know

In 2025, the out-of-pocket limit for drug costs set by the Inflation Reduction Act (IRA) was $2,000; in 2026, that amount will increase to $2,100.

Flexibility for drug payments.

Medicare members with Part D coverage can spread their prescription drug out-of-pocket costs into monthly payments over the course of the plan year.
Costs are billed by your insurer.
This program can be valuable for members with high drug costs at the start of the plan year. (Note: If you add or remove prescriptions during the year, your monthly payment will change.)
Enrollment is voluntary, and you will need to opt in through your plan provider.

Learn more

If you have Medicare Part D coverage, the IRA limits your out-of-pocket maximum for covered prescription drugs to $2,100 in 2026. Your premiums, copays, coinsurance or deductibles may be different compared to what you paid in 2025.

Additional resources and materials

Explore articles and FAQs for more in-depth information about Medicare Part D, so you can make confident decisions about your health insurance coverage.

What to know about Medicare Part D deductibles

Learn about Medicare Part D deductibles and how the Inflation Reduction Act (IRA) is simplifying drug coverage stages and lowering the out of pocket maximum for Medicare Part D members.

How does the Inflation Reduction Act affect Medicare?

The Inflation Reduction Act (IRA) is a federal law that makes improvements to the Medicare program. Among other things, the IRA will expand Medicare benefits and help reduce Medicare members’ out-of-pocket costs for prescription drugs.

Medicare Part D changes

What changes are coming to Medicare Part D in 2026?

Maximum out-of-pocket drug cost

Part D prescription drug deductible

What to know about Medicare Part D prescription drug deductibles in 2026

Video transcript

Find the right Medicare plan for all your plans

Here's what you need to know

New out-of-pocket maximum

The Medicare Prescription Payment Plan

How recent changes may affect Medicare members

Additional resources and materials

What to know about
Medicare Part D prescription drug deductibles in 2026