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Medicare Advantage and Medicare Prescription Drug Programs Are Expected to Stay Stable in 2026

6 months ago 36

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On Friday, September 26, CMS announced that average premiums, benefits, and plan choices for the Medicare Advantage (MA) and Medicare Part D prescription drug programs are expected to remain stable in 2026. Average premiums are projected to decline in both the MA and Part D programs from 2025 to 2026, according to the press release.

CMS estimated that the average monthly premium for all MA plans, including plans with prescription drug coverage and MA Special Needs Plans (SNPs), will decrease from $16.40 in 2025 to $14.00 in 2026. According to plans’ projections, enrollment in MA is expected to be 34 million in 2026, down from 34.9 million in 2025, with MA enrollment making up approximately 48 percent of all Medicare beneficiaries, compared to 50 percent in 2025.

The press release further stated that CMS has taken steps to hold standalone prescription drug plan (PDP) sponsors accountable for substantial year-over-year premium increases and has used its authority to negotiate bid terms and conditions successfully.

Furthermore, CMS announced that the average total premium for stand-alone Part D plans is expected to decrease from $38.31 in 2025 to $34.50 in 2026. After applying MA rebates—which reflect what people in MA plans with prescription drug coverage will pay—the average total premium for MA plans with prescription drug coverage is projected to fall from $13.32 in 2025 to $11.50 in 2026.

Medicare Open Enrollment begins October 15, 2025, and ends December 7, 2025. “We want every beneficiary to take advantage of Open Enrollment—compare your options and choose the plan that gives you the right care at the best price,” CMS Administrator Dr. Mehmet Oz said in a statement.

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