Medicare Part D Changes: What Caregivers and Seniors Really Need to Know

As a caregiver, I've learned that when a headline mentions cuts to Medicare, it's hard not to worry.

Recently, I started seeing articles and social media posts about changes to Medicare Part D. Some headlines suggested seniors could lose benefits, while others warned of significant increases in prescription drug costs. Like many caregivers, I wanted to know what was really happening.

So, I spent some time researching the issue, reading information from Medicare, the Centers for Medicare & Medicaid Services (CMS), and independent policy experts. What I found was far less alarming than many of the headlines suggested.

While there are changes coming to a temporary Medicare Part D subsidy program, Medicare Part D itself is not going away, and many seniors may experience little or no impact on their prescription coverage.

Let's look at what is changing and what caregivers need to know.

First Things First: Medicare Part D Is Not Going Away

One of the biggest misconceptions circulating online is that Medicare Part D is being eliminated.

That is not true.

Medicare Part D, which provides prescription drug coverage for Medicare beneficiaries, remains in place. Seniors will continue to have access to prescription drug plans and Medicare Advantage plans that include prescription coverage.

So, What Is Changing?

The change receiving the most attention involves a temporary government program known as the Part D Premium Stabilization Demonstration.

This program was created to help keep Medicare Part D premiums from rising too quickly after recent changes to the prescription drug benefit. The government provided financial support to participating insurance plans to help keep costs stable for beneficiaries.

In 2025, that support was worth up to $15 per member per month, and in 2026 it was reduced to $10 per member per month. The program is currently scheduled to end after 2026.

It's important to understand that this assistance was provided to insurance plans to help stabilize premiums, not as a direct payment to beneficiaries.

Does This Mean Prescription Costs Will Increase?

Possibly, but not necessarily by a large amount.

Without the stabilization program, experts estimated that many Part D premiums would have increased substantially. The Government Accountability Office found that average standalone Part D premiums could have nearly doubled for some beneficiaries without the demonstration program. About 37% of beneficiaries would have seen premium increases of more than $40 per month.

Instead, average premiums remained relatively stable, increasing from approximately $42 to $43 per month for beneficiaries who did not qualify for the Low-Income Subsidy.

As the program ends, some beneficiaries may see higher premiums in 2027. CMS officials have suggested that many beneficiaries may see increases of less than $10 per month, but final costs will depend on the specific plan, region, and drug coverage details. Independent experts note that some plans could still see larger increases.

It is also important to know that Medicare Part D now includes an annual out-of-pocket cap for covered prescription drugs. In 2026, that cap is $2,100. This does not mean every medication will be inexpensive, and it does not include monthly premiums, but it does provide important protection for people who take costly medications. Once a beneficiary reaches the cap, they pay $0 for covered Part D drugs for the rest of the calendar year.

Caregivers may also hear people refer to the old Medicare Part D “donut hole.” Under the redesigned Part D benefit, that old coverage-gap structure has changed. The benefit is now easier to understand: beneficiaries move through their deductible and regular plan cost-sharing until they reach the annual out-of-pocket cap for covered drugs.

A Common Point of Confusion: What About Extra Help?

This is where many people understandably get confused.

The temporary subsidy program that's ending is not the same thing as Medicare's Low-Income Subsidy (LIS), also known as Extra Help.

Extra Help is an ongoing Medicare program that assists eligible beneficiaries with:

• Part D premiums

• Deductibles

• Prescription copayments

For qualifying individuals, Extra Help can significantly reduce out-of-pocket prescription costs.

Currently, Extra Help remains available for eligible beneficiaries and is not the program that is being eliminated.

Who Might Feel the Greatest Impact?

The people most likely to notice any premium increases are often those who:

• Do not qualify for Extra Help

• Live on fixed incomes

• Fall just above the income limits for assistance programs

• Pay their own standalone Part D premiums each month

  
  

For these individuals, even a modest monthly increase can make budgeting more challenging.

What Can Caregivers Do Right Now

Helping loved ones understand Medicare changes starts with clear information and calm conversations.

Before worrying about future changes, there are several practical steps caregivers can take.

Review Coverage During Open Enrollment

Medicare plans change annually. Taking time to compare plans during Open Enrollment can help ensure your loved one continues to receive the best coverage for their medications. Do not look only at the monthly premium. Check whether each medication is still on the plan’s formulary, what tier it is placed in, whether prior authorization is required, and which pharmacies are preferred.

Check Eligibility for Extra Help

Some seniors assume they won't qualify and never apply. It may be worthwhile to revisit eligibility requirements, especially if financial circumstances have changed.

Review Medications With a Pharmacist

A pharmacist may be able to identify lower-cost alternatives, generic versions, or medications that are covered more favorably by a particular plan.

Focus on Facts Instead of Headlines

Healthcare news often gets condensed into attention-grabbing headlines that may not tell the whole story. Whenever possible, look to trusted sources and verify information before assuming the worst.

The Bottom Line

The recent Medicare Part D news is largely about the expiration of a temporary premium-stabilization program, not the elimination of prescription drug coverage.

Medicare Part D is still here. Extra Help remains available for qualifying beneficiaries. While some seniors may see premium increases in future years, the impact will vary based on their plan, income assistance eligibility, and location.

As caregivers, we spend much of our time helping our loved ones navigate a healthcare system that can feel overwhelming and confusing. When I first heard about Medicare Part D changes, I wasn't sure what to believe. After doing the research, I came away feeling better informed and a lot less worried.

My hope is that this information helps you feel the same way.

The best thing we can do is stay informed, ask questions, and focus on facts rather than frightening headlines. Our loved ones are counting on us to help them navigate these changes, and knowledge is one of the most valuable tools we have. ❤️

NOTE: Open enrollment starts October 15, 2026 and ends December 7, 2026. If you need help navigating or finding the coverage that's right for you, contact our partner Medicare Resource Group. (914) 475-9800

Sources / Where to Find the Articles Referenced

Government Accountability Office (GAO): Medicare Part D: Implementation of Beneficiary Premium Stabilization Demonstration — https://www.gao.gov/products/gao-26-107935

GAO Full Report: Medicare Part D: Implementation of Beneficiary Premium Stabilization Demonstration — https://files.gao.gov/reports/GAO-26-107935/index.html

Centers for Medicare & Medicaid Services (CMS): 2026 Medicare Part D Bid Information and Part D Premium Stabilization Demonstration Parameters — https://www.cms.gov/newsroom/fact-sheets/2026-medicare-part-d-bid-information-and-part-d-premium-stabilization-demonstration-parameters

CMS PDF: July 28, 2025 Parts C & D Announcement — https://www.cms.gov/files/document/july-28-2025-parts-c-d-announcement.pdf

Medicare.gov: Medicare & You 2026 Handbook — https://www.medicare.gov/publications/10050-medicare-and-you.pdf

Medicare.gov: Your Medicare in 2026: What You Need to Know — https://www.medicare.gov/publications/12229-your-medicare-in-2026-what-you-need-to-know.pdf

Congressional Research Service: Medicare Part D Premium Stabilization Demonstration — https://www.congress.gov/crs_external_products/IF/PDF/IF12889/IF12889.2.pdf

Center for Medicare Advocacy: Scale Back of Demo Project Drives Higher Part D Plan Costs — https://medicareadvocacy.org/scale-back-of-demo-project-drives-higher-part-d-plan-costs/

Center for Medicare Advocacy: 2026 Part D Reminders for Beneficiaries — https://medicareadvocacy.org/2026-part-d-reminders-for-beneficiaries/