If you’re enrolled in a Medicare prescription-drug plan (Part D) or have drug coverage through a Medicare Advantage plan, you might assume that once you’re set you’re good. But in fact, reviewing your plan each year is critical. For 2026 the landscape has shifted enough that a little time spent now could save you hundreds of dollars (or more) in premiums, deductibles and out-of-pocket costs.
In this post I’ll walk through nine key sections: what’s changed, why it matters, how to review effectively, and what steps you should take. By the end, you’ll have a clear map of how to review your plan and why it isn’t just busy work it’s a money-saving move.
Understanding the 2026 Changes to Medicare Drug Coverage
First, let’s outline what has changed for 2026 in the world of Medicare drug coverage. For example: the yearly out-of-pocket cap for Part D drugs will be $2,100 in 2026. Also, all stand-alone Part D plans will have options with premiums lower than what many paid in 2025.
These changes matter because they shift how much you may pay and how to shop. Even if you keep the same plan, its terms may change: formularies may shift, tier placement may change, and copays or coinsurance may adjust. In other words, you’re no longer locked into “set it and forget it.” You need to check.
Importantly, the fact that many plans for 2026 will offer lower premiums means you could be paying more than you have to simply by staying put. And since Medicare’s official handbook warns: “you should review your health care needs for the upcoming year and determine if you would benefit from changing coverage.” So reviewing is not optional if you want to avoid missing savings.
Why “Automatic Renewal” Can Cost You Money
It’s tempting to do nothing. After all, you’ve got coverage, and why rock the boat? Yet that inaction can cost you. If you automatically stay in your current plan without review, you may miss out on savings due to shifting drug lists (formularies), pharmacies preferred by the plan, or simply better options elsewhere.
For instance, your current plan may change which drugs it covers in which tier or may raise copays for certain drugs. Even minor changes can result in unexpectedly higher costs. Because of that, ignoring your plan is essentially choosing to accept potentially higher expenses.
In addition, premiums for some plans have dropped, and new plans have emerged for 2026 with more favourable terms. As noted, 100% of people with a standalone Part D plan will have access to a plan with a lower premium than what they paid in 2025. By failing to review, you leave money on the table.
Identifying Your Prescription Drug Needs for 2026
Before you compare plans, you need to know what you will need. Create a list of the prescription drugs you expect to take in 2026: the name, dosage, how often you take it, and whether it’s brand or generic. Also check what pharmacy you use (or prefer) and whether you are open to using mail‐order or network pharmacies.
By knowing your drug “profile” you’ll be able to more accurately compare plans. If you don’t do this, you might select a plan based mostly on premium rather than true cost – and miss where copays or tiers blow you up.
Another point: think about whether your health situation will change. Perhaps you anticipate needing a new drug, or dropping one. By forecasting what you’ll need, you put yourself ahead of the curve rather than reacting when the bills arrive.
Using the Medicare Plan Finder and Comparison Tools
One of the most powerful tools at your disposal is the official Medicare Plan Finder (on Medicare.gov). This tool allows you to input your drugs, your preferred pharmacy, and your current state/zip, and then compare plans side by side. Medicare
When you use that tool, pay close attention not just to premium but also to: deductible (if any), formulary (does your drugs appear and in which tier), copays/coinsurance, preferred pharmacies, and the out-of-pocket maximum (especially for 2026 the cap of $2,100).
Also make sure to check the “Annual Notice of Change” your plan sends you each fall. That notice will tell you what will change for the next year (premium, drug tiers, pharmacy network). Use that as a starting point for review.
Comparing Premiums, Deductibles, and Out-of-Pocket Costs
When looking at plans, premium isn’t everything. A plan with a slightly higher premium might save you money if it has lower copays for your drugs or a lower deductible. For 2026, the out-of-pocket cap for Part D drugs is important: once you hit that cap, you won’t have to pay further for covered drugs.
For example, one plan might have a $0 deductible but higher copays; another might have a $250 deductible but very low copays for your key drugs. Which is better depends on your personal usage. You should run sample cost estimates: if you expect to take one or two expensive drugs, it might be worth paying a little more premium for lower copays.
In short: don’t pick a plan based on “lowest premium” alone. Evaluate total projected cost: premium + deductible + copays + out-of-pocket maximum. That’s how you find the one that will save you hundreds.
Checking Formulary and Pharmacy Networks
A major reason reviewing matters: your current plan may change the drugs it covers or the tier placement for your drugs. If you don’t verify, you may find in 2026 your drug is moved to a higher tier or excluded entirely. The official guide notes “the amount you pay will also depend on the tier level assigned to your drug.”
Also, pharmacy networks matter. Some plans prefer you use certain pharmacies (or mail-order) for lower cost. If you consistently use a local pharmacy that is moved out of network, you could see higher costs or inconvenience. So check: does your preferred pharmacy remain in network? If not, does plan still make sense?
Because of this, part of your review process should be: cross-check each drug you take, make sure it is still listed in your plan’s formulary, check its tier, check your pharmacy options. If you find major changes, it’s a strong sign you should consider switching plans.
Understanding the Time Window
It’s easy to procrastinate; but there is a time window beyond which you may lose the chance to change plans. For Medicare drug plans, the open enrollment period matters. The official handbook emphasises that you should review coverage for the upcoming year.
Usually the annual enrollment period (AEP) runs from October 15 to December 7, during which you can change your plan and have new coverage begin January 1. Missing that window means you may have to wait another year or pay penalties. You don’t want to delay. Start early: receive your plan’s “Annual Notice of Change” as soon as it arrives (typically early fall), review it, then act if needed.
Also, when you choose a new plan, follow the steps carefully: enroll via the official site or contact the plan, confirm effective date, keep proof of your new selection. Doing this sooner rather than later gives you time to review and avoid mistakes.
Case Studies
Let’s walk through a couple of hypothetical scenarios to illustrate how review could lead to savings.
Scenario A: Jane takes two brand-name medications and a generic. Her current plan has a moderate premium, but for 2026 her plan increases her brand-name copays significantly and moves one drug to a higher tier. After comparing plans, she switches to one with slightly higher premium but much lower copays for her drugs. Over the year she saves $350 in copays, making up for the premium difference and then some.
Scenario B: Mark is mostly on generics and uses mail‐order pharmacy. His current plan still covers his drugs, but the deductible is higher than a competing plan. By switching to a plan with a $0 deductible and similar premium, he saves over $200 and reduces out-of-pocket risk.
These examples show: by taking the time to review, you can avoid surprise cost hikes and position yourself for savings. On the flip side, if you don’t review, you may find yourself paying more without even realising.
Additional Tips and Common Pitfalls to Avoid
Here are some extra tips to make your review more effective, and pitfalls to avoid:
- Tip: Keep a running list of all medications (with dosage) and preferred pharmacy before you shop. That lets you plug numbers into comparison tools easily.
- Tip: Don’t just compare the two cheapest plans; compare any plan where your drugs are favourably placed. The “lowest tier for your drugs” often matters more than lowest premium.
- Tip: Check if your plan offers mail‐order or multi‐month prescriptions these can cut cost further.
- Pitfall: Don’t assume “my plan hasn’t changed much” means you’re safe. Coverage terms often shift quietly; you must verify.
- Pitfall: Don’t ignore provider networks or pharmacy changes. A change here could mean more travel, inconvenience or higher cost.
- Pitfall: Don’t delay. Waiting until late December could leave you with fewer choices.
While we’re focused on drug plans, sometimes people look at other therapies or medications (for example, weight-related medications) and consider how they might or might not be covered. In fact, certain weight-loss medications and off-label uses may not be covered under your plan, so understanding formulary status is crucial. (For example, you might read about how people attempt to buy mounjaro weight loss injections uk or similar therapies while interesting, these kinds of purchases may not be supported under your Medicare drug plan, underscoring the need to check coverage.)
Final Checklist
To wrap up, here’s a simple checklist of actions you can take right now to review your plan:
- Gather your list of medications (name, dosage, frequency) and preferred pharmacy.
- Review your current plan’s “Annual Notice of Change” to see what changes for 2026.
- Use the Medicare Plan Finder tool to compare available plans in your area, entering your drugs and pharmacy.
- Check premium, deductible, copays/coinsurance, out-of-pocket cap ($2,100 for 2026) and pharmacy network.
- Compare at least two or three plans where your key drugs are optimally placed.
- If you find a better plan, enroll by the deadline (October 15 through December 7) so changes take effect January 1.
- Keep documentation of your enrollment and monitor mail for confirmation.
- For extra caution, re-check in early January to make sure your pharmacy transfers, copays and tiers are functioning as expected.
If you complete this checklist, you’ll significantly increase the chance you’ll save hundreds of dollars (or more) in 2026. Conversely, skipping this review means you’re likely leaving money on the table.
In Closing
Reviewing your Medicare drug plan for 2026 is one of those actions that takes only a little time but can make a big difference for your budget and your care. With lower premiums available, shifting formularies, and the new out-of-pocket cap, the landscape is changing. Don’t assume your current plan is still the best.
Instead, treat this review as a smart financial-health move. Gather your info, compare, act. Your future self (and your wallet) will thank you.