This Just In ...
Medicare Part D Out-of-Pocket Cap Increases to $2,100 in 2026

Thanks to the continued rollout of the Inflation Reduction Act, Medicare Part D enrollees will see their annual out-of-pocket prescription drug costs capped at $2,100 starting January 1, 2026. This builds on the $2,000 cap introduced in 2025, offering continued relief for seniors managing high-cost medications.

Before these reforms, beneficiaries faced unlimited drug costs once they entered the catastrophic coverage phase. Now, with a firm ceiling in place, you’ll have predictable protection—especially if you take medications for cancer, diabetes, heart disease, or autoimmune conditions.

What This Means for You in 2026

• The $2,100 cap applies across all Part D plans, including stand-alone drug plans and Medicare Advantage plans with drug coverage.
• Once you reach the cap, your plan covers 100% of additional drug costs—no more tracking the “donut hole” or catastrophic phase.
• Insulin remains capped at $35/month, and CDC-recommended vaccines are still free.
• Extra Help (Low-Income Subsidy) eligibility has expanded, making coverage more affordable for many.

Why This Matters Now

Open Enrollment is your once-a-year opportunity to:

• Review your plan’s 2026 formulary
• Confirm your medications are covered
• Compare premiums, copays, and pharmacy networks
• Talk to your agent about how the new cap affects your total drug spending

Agents are already helping clients evaluate their 2026 options. If you or a loved one are on Medicare, now’s the time to take stock and make sure your plan is aligned with your health and budget needs.

In this issue:

This Just In ... Medicare Part D Out-of-Pocket Cap Increases to $2,100 in 2026

Medicare Drug Coverage Is Changing—Here’s What You Need to Know This Enrollment Season

Aging Alone: Why Long-Term Care Planning Matters More Than Ever

Never Outlive Your Savings: How Longevity Annuities Can Help

Traveling Abroad with Medicare: What You Need to Know

The information presented and conclusions within are based upon our best judgment and analysis. It is not guaranteed information and does not necessarily reflect all available data. Web addresses are current at time of publication but subject to change. SmartsPro Marketing and The Insurance 411 do not engage in the solicitation, sale or management of securities or investments, nor does it make any recommendations on securities or investments. This material may not be quoted or reproduced in any form without publisher’s permission. All rights reserved. ©2023 The Insurance 411. www.theinsurance411.com Tel. 877-762-7877.