Your Medicare prescription drug plan (PDP) monthly premium could be going up by over $100 — but it doesn’t have to.
Medicare’s annual open enrollment period is underway. Until Dec. 7, you can go online to review your coverage and make changes to your Medicare PDP. But only about one in five PDP participants do, even though failing to shop around could leave money on the table.
That’s especially true this year.
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Overall, the changes to PDP premiums are modest. The Centers for Medicare & Medicaid Services predicts that the average Part D premium will increase by less than $1 per month. But depending on which plan you have, your monthly premium could increase by much more.
Switching to a new plan could save you hundreds of dollars next year.
Here’s what to know about the changes coming to Medicaid next year, as well as what you should look out for when picking out a new plan.
AARP plans see the highest premium increases
If you have an AARP-branded PDP, you could have the most to gain by switching your Part D plan. Premiums for the AARP Medicare RX Preferred plan will increase by more than $50 per month in every state, as well as Washington, D.C. In four states (California, Florida, New York and Pennsylvania), the monthly premium increase will exceed $100.
Holders of the AARP Medicare Rx Saver plan should also review their coverage. Premiums will rise by more than $50 per month for beneficiaries in 33 states.
Those two plans cover over 2 million enrollees, meaning a significant chunk of Part D holders will be impacted by these increases.
The good news is that more affordable plans are available for AARP PDP users in every single state. The bad news is that you’ll have fewer other options to choose from. For the fourth consecutive year in a row, the average number of PDPs people will have to choose from dropped, going from 11 to nine.
If you previously relied on a $0 premium PDP, you might be out of luck. Medicare Part D no longer offers $0 premium PDPs to people who aren’t receiving low-income subsidies. That means that almost 30% of current PDP beneficiaries[g] who don’t qualify for low-income subsidies will have to start paying each month for their drug plan after not paying a premium in 2026.
Still, there are low-cost options available for people who don’t have the budget to spend on high-premium drug plans.
If you’re among the 55% of Medicare beneficiaries who are on a Medicare Advantage plan, then none of this affects you. But you should still check your Medicare Advantage coverage during open enrollment; you might be one of the million Americans losing their MA plan.
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What to check for your Medicare PDP during enrollment
If you have a Medicare Part D plan, you have until December 7 to log on to the Medicare portal and choose a new plan.
When looking for a new plan, you should definitely keep an eye out for premium costs. But that’s not all you should look out for.
You’re likely already on some prescribed drugs that work for you. Whatever plan you switch to isn’t guaranteed to cover those drugs; make a list of what drugs you take at what dosages and check to see if they’re covered under the plans you’re interested in.
Similarly, make sure whatever pharmacy you use to pick up your drugs is covered under your new plan.
If your drugs are covered with a higher copay, consider how much extra you’ll pay for that drug over the course of a year. A higher-premium plan might be worth it if the amount you’ll save in drug costs is high enough.
You’ll also want to consider how high your Part D deductible would be before you commit to any specific plan. A higher-premium but zero-deductible plan might save you money over a $700 deductible, lower-premium plan, depending on your specific pharmacy needs.
If, after doing the math, you’re struggling to fit higher premiums or drug prices into your budget, help may be available. Social Security offers a Medicare Part D Extra Help program for people who are struggling to pay for the medicine they need.
CMS did not immediately respond to a request for comment.
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Kit Pulliam is a DC-based financial journalist with over five years of experience writing, editing and fact-checking financial content.
