Medicare Part D: How to Save on Prescriptions in 2026

Last updated: March 22, 2026

2026 is the most significant year for Medicare prescription drug savings in decades. The Inflation Reduction Act (IRA) introduced sweeping changes that directly reduce what you pay at the pharmacy. This guide covers every savings lever available to Medicare Part D beneficiaries.

The $2,000 Out-of-Pocket Cap

Starting January 1, 2026, Medicare Part D beneficiaries will never pay more than $2,000 per year in out-of-pocket prescription drug costs. This is the single biggest change in Part D history.

Before 2026, patients in the “catastrophic” coverage phase still paid 5% of drug costs indefinitely. For someone taking a $15,000/year cancer drug, that meant $750/year even after hitting the coverage gap. Now, once you reach $2,000, your plan covers 100% for the rest of the year.

Medicare Prescription Payment Plan: You can also spread your out-of-pocket costs across the year in monthly installments. Instead of paying $2,000 upfront in January, you can pay roughly $167/month. Ask your Part D plan about enrollment.

IRA Negotiated Drug Prices

The federal government has negotiated prices for the first batch of high-cost drugs. These negotiated prices took effect January 1, 2026, and apply to all Medicare Part D plans. The initial 10 drugs include some of the most commonly prescribed medications:

  • Eliquis (apixaban) — blood thinner, negotiated to $231/mo
  • Jardiance (empagliflozin) — diabetes/heart failure
  • Xarelto (rivaroxaban) — blood thinner, negotiated to $197/mo
  • Entresto (sacubitril/valsartan) — heart failure

More drugs will be added in future years. Check your specific medication using our savings tool to see if a negotiated price applies.

Extra Help (Low Income Subsidy)

If your income is below 150% of the Federal Poverty Level (about $22,590/year for an individual in 2026), you may qualify for Extra Help, which can reduce Part D premiums, deductibles, and copays to near zero.

2026 Change: The IRA expanded full Extra Help benefits to those at 150% FPL (previously the full benefit cutoff was 135% FPL). This means hundreds of thousands more beneficiaries now qualify for the most generous assistance.

How to Apply for Extra Help

  1. Apply online at ssa.gov/medicare/part-d-extra-help
  2. Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778)
  3. Visit your local Social Security office
  4. Contact your State Health Insurance Assistance Program (SHIP)

Medicare Savings Programs (MSPs)

MSPs are state-administered programs that help pay Medicare premiums, deductibles, and coinsurance. There are four levels:

  • Qualified Medicare Beneficiary (QMB): Covers Part A and B premiums, deductibles, and coinsurance. Income limit: 100% FPL.
  • Specified Low-Income Medicare Beneficiary (SLMB): Covers Part B premium. Income limit: 120% FPL.
  • Qualifying Individual (QI): Covers Part B premium. Income limit: 135% FPL.
  • Qualified Disabled and Working Individual (QDWI): Covers Part A premium. Income limit: 200% FPL.

Enrolling in an MSP also automatically qualifies you for Extra Help. Apply through your state Medicaid office.

Patient Assistance Programs for Medicare

Some manufacturer PAPs accept Medicare patients, though eligibility is more restricted than for uninsured patients. Notable programs that accept Medicare beneficiaries:

Search your medication in our savings tool to see if a PAP is available for Medicare patients.

Insulin: $35/Month Cap

All Medicare Part D plans now cap insulin copays at $35 per monthper covered insulin product. This applies in the deductible phase, initial coverage phase, and coverage gap. No application is needed — the cap is automatic.

See savings options for specific insulins: Humalog, Novolog, Lantus, Tresiba.

Free Vaccines Under Part D

As of 2023, all Part D-covered vaccines are free with no copay. This includes shingles (Shingrix), Tdap, and other adult vaccines that were previously subject to cost-sharing.

What You Should Do Right Now

  1. Check if your drugs have negotiated prices. Use our savings tool to look up each medication.
  2. Apply for Extra Help if your income is below 150% FPL. Even if you were denied before, the 2026 expansion may make you eligible.
  3. Ask about the Prescription Payment Plan. Call your Part D plan and ask to spread your OOP costs across monthly installments.
  4. Review your plan during Open Enrollment (October 15 - December 7). The new OOP cap means plan comparisons look different now.
  5. Check manufacturer PAPs. Even with Medicare, some programs can provide free medication.

Find Your Medicare Savings

Enter your medication and select “Medicare” to see every available discount, negotiated price, and assistance program.

Check your savings →