Your Guide to Medicare's 2026 Prescription Drug Discounts
If you’re on Medicare, you may have heard talk about big changes coming to prescription drug costs. The good news is that for many, relief is on the way. We’ll walk you through exactly what’s happening, which drugs are affected first, and how you can check if your medications are included.
Understanding the New Medicare Drug Price Negotiations
For the first time, a new law allows Medicare to negotiate directly with drug manufacturers to lower the prices of some of the most expensive prescription drugs. This change is part of the Inflation Reduction Act of 2022, a law designed to reduce healthcare costs for seniors.
This is a significant shift. In the past, Medicare was not permitted to negotiate drug prices. Now, the government can work to get a better price on behalf of millions of beneficiaries. This process is being rolled out in phases, with the first negotiated prices set to take effect on January 1, 2026. Each year, more drugs will be added to the negotiation list, leading to broader savings over time.
The goal is to make essential medications more affordable and reduce the overall spending for both you and the Medicare program. This is different from a temporary discount or a coupon; it’s a fundamental change to how the price is set for certain high-cost medications.
The First 10 Drugs with Lower Prices in 2026
The Centers for Medicare & Medicaid Services (CMS) has already announced the first 10 drugs covered under Medicare Part D that have been selected for price negotiation. If you take one of these medications, you are likely to see lower out-of-pocket costs starting in 2026.
Here is the official list of the first 10 drugs, along with their common uses:
- Eliquis: Used to prevent blood clots and reduce the risk of stroke in people with atrial fibrillation.
- Jardiance: Used to treat type 2 diabetes and reduce the risk of cardiovascular death in adults with heart disease.
- Xarelto: Another medication used to prevent and treat blood clots.
- Januvia: Used to help control blood sugar levels in adults with type 2 diabetes.
- Farxiga: Used to treat type 2 diabetes, heart failure, and chronic kidney disease.
- Entresto: A prescription medication used to treat certain types of heart failure.
- Enbrel: Used to treat several autoimmune conditions, including rheumatoid arthritis and psoriasis.
- Imbruvica: A treatment for certain types of blood cancers, such as mantle cell lymphoma and chronic lymphocytic leukemia.
- Stelara: Used to treat plaque psoriasis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis.
- Fiasp; Fiasp FlexTouch; Fiasp PenFill; Novolog; Novolog FlexPen; Novolog PenFill: These are fast-acting insulin products used to manage blood sugar in people with diabetes.
The final negotiated prices for these specific drugs are scheduled to be published by September 1, 2024, and will become effective on January 1, 2026.
How to Check if Your Medications Are Included
The most direct way to see if you’ll be affected by the first round of discounts is to check the list above. If your medication is on it, you are in the group that will see changes in 2026. But what if your drug isn’t listed? Here’s how to stay informed for the future.
1. Watch for Future Announcements
This is just the beginning. More drugs will be added to the negotiation list in the coming years.
- For 2027: An additional 15 Part D drugs will be selected.
- For 2028: Another 15 drugs (from Part D and Part B) will be selected.
- For 2029 and beyond: 20 new drugs will be selected each year.
The best place for official information is the source. You can check the official Medicare website at Medicare.gov for updates on the drug price negotiation program.
2. Talk to Your Doctor or Pharmacist
Your healthcare providers are your best resource. They know your medical history and the specific prescriptions you take. Ask them during your next visit if they are aware of any upcoming price changes for your medications. They can also help you identify if there are lower-cost alternatives available now.
3. Review Your Annual Notice of Change (ANOC)
Every September, your Medicare Part D or Medicare Advantage plan provider will mail you an “Annual Notice of Change” document. This is a critical document that outlines all the changes to your plan for the upcoming year, including changes in drug coverage and costs. As the new negotiated prices take effect, they will be reflected in these notices. Make it a habit to review this document carefully each fall.
Other Important Changes Lowering Your Drug Costs
The price negotiations for 2026 are just one piece of the puzzle. The Inflation Reduction Act has already introduced other powerful cost-saving measures for Medicare beneficiaries.
- $35 Monthly Cap on Insulin: As of 2023, your monthly out-of-pocket cost for each covered insulin product is capped at $35. This is a major saving for millions of Americans with diabetes.
- Free Recommended Vaccines: All adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP), such as the shingles vaccine, are now available at no cost to you.
- A New $2,000 Out-of-Pocket Cap (Starting in 2025): This is a landmark change. Starting in 2025, your annual out-of-pocket spending on prescription drugs under Medicare Part D will be capped at $2,000. Once you reach this limit, you will pay $0 for your prescription drugs for the rest of the year. This eliminates the fear of catastrophic drug costs for those with expensive medical conditions.
These changes work together to make prescription drugs more affordable and predictable for everyone on Medicare.
Frequently Asked Questions
What if my drug isn’t on the first list? Don’t worry. The list of negotiated drugs will grow every year. Keep an eye on official announcements from Medicare and talk to your doctor about your options. The new $2,000 out-of-pocket cap in 2025 will also provide significant financial protection regardless of which drugs you take.
Do these discounts apply to Medicare Advantage plans too? Yes. These changes apply to all Medicare prescription drug plans, including standalone Part D plans and Medicare Advantage plans that include drug coverage (MA-PD).
When will I know the exact new price for a drug like Eliquis or Jardiance? The government and manufacturers are currently in the negotiation process. The first round of new, negotiated prices will be made public by September 1, 2024. These prices will then go into effect on January 1, 2026.