At Insurance Options of the Carolinas, we want to make sure you’re informed and ready for the upcoming Medicare changes in 2026. Several updates to Medicare Part D may impact your prescription drug coverage and costs.
1. Out-of-Pocket Spending Cap
One change is the new $2,100 annual out-of-pocket maximum for prescription drugs. This means that once you spend $2,100 on covered medications in 2026, you won’t pay anything more for the rest of the year.
2. Elimination of the Coverage Gap
The well-known “donut hole” or coverage gap went away in 2025. This change will make costs more predictable and easier to manage throughout the year.
3. Option to Spread Out Costs
In 2026, you will be able to choose to spread your out-of-pocket costs evenly throughout the year instead of paying larger amounts all at once. This could be helpful for budgeting and cash flow.
4. Insulin & Vaccine Costs
Insulin will continue to be capped at $35 per month, and recommended adult vaccines will remain at no cost under Part D.
5. Plan Reviews Are More Important Than Ever
Please ensure you open your mail and review the renewal changes for 2026. Reviewing your Part D plan during Medicare’s Annual Enrollment Period (October 15 – December 7) will be crucial. Ensuring your prescriptions are covered at the lowest cost can save you hundreds of dollars. If you need assistance, just call the office.
At Insurance Options of the Carolinas, we are here to help you navigate these changes and choose the plan that best fits your needs. If you have questions or want to schedule a review, contact us today:
Bonnie L. Krempa
Insurance Options of the Carolinas
📧 bonnie@4insuranceoptions.com
📞 704.618.3800