Your Guide to Medicare's 2026 Prescription Drug Discounts

You’ve likely heard about upcoming changes to Medicare that could lower your prescription drug costs, and you want to know how to check if your medications are included. We’ll walk you through exactly what’s happening, list the first drugs with negotiated prices, and show you how to stay informed.

Understanding the Big Changes to Medicare Drug Pricing

For years, the cost of prescription drugs has been a major concern for many people on Medicare. A significant change came with the passage of the Inflation Reduction Act of 2022. This law gave Medicare a powerful new tool: the ability to negotiate drug prices directly with pharmaceutical companies for the first time.

This negotiation process aims to make some of the most expensive prescription drugs more affordable for millions of seniors. The new, lower prices for the first group of selected drugs are scheduled to take effect on January 1, 2026. It’s important to understand that this is a gradual rollout. A small group of drugs has been selected for the first round of negotiations, and more will be added in the years to come. This means that even if your medication isn’t on the initial list, it could be included in the future.

How to Check: The First 10 Drugs Selected for Negotiation

The Centers for Medicare & Medicaid Services (CMS) has announced the first 10 drugs covered under Medicare Part D that were selected for price negotiation. If you take any of these medications, you are likely to see lower out-of-pocket costs starting in 2026.

Here is the list of the first 10 drugs and their primary uses:

• Eliquis (Apixaban): Used to prevent blood clots and reduce the risk of stroke in people with atrial fibrillation.
• Jardiance (Empagliflozin): Used to treat type 2 diabetes and reduce the risk of cardiovascular death in adults with heart disease.
• Xarelto (Rivaroxaban): Another common medication used to prevent and treat blood clots.
• Januvia (Sitagliptin): Used to help control blood sugar levels in adults with type 2 diabetes.
• Farxiga (Dapagliflozin): Used for treating type 2 diabetes, heart failure, and chronic kidney disease.
• Entresto (Sacubitril/Valsartan): A combination medicine used to treat certain types of heart failure.
• Enbrel (Etanercept): A biologic drug used to treat rheumatoid arthritis and other autoimmune conditions.
• Imbruvica (Ibrutinib): A targeted therapy used to treat certain types of blood cancers, like mantle cell lymphoma and chronic lymphocytic leukemia.
• Stelara (Ustekinumab): Used to treat psoriasis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis.
• Fiasp; Novolog (Insulin Aspart): A rapid-acting insulin used to manage blood sugar levels in people with type 1 and type 2 diabetes.

If you see your medication on this list, your costs for that specific drug should decrease once the negotiated prices go into effect in 2026. The exact savings will be announced after the negotiation period ends in 2024.

A Step-by-Step Guide to Staying Updated

The list of drugs eligible for negotiation will grow over time. Knowing where to find the most current and reliable information is key. Here is how you can stay on top of these changes.

Step 1: Talk to Your Doctor or Pharmacist

Your healthcare providers are your best resource. They know your medical history and the specific drugs you take. Ask them if your prescriptions are on the negotiation list or if there are alternative medications that might be more affordable for you.

Step 2: Visit the Official Medicare Website

The most accurate source for all information related to these changes is the official government website. You can visit Medicare.gov for updates on the drug price negotiation program. The government is committed to transparency and will post the final negotiated prices once they are available.

Step 3: Understand the Timeline for Future Additions

It’s helpful to know when to expect more drugs to be added to the negotiation list. This allows you to plan and check back for updates periodically. The official timeline is:

• For 2026: The first 10 Part D drugs (listed above).
• For 2027: An additional 15 Part D drugs will be selected.
• For 2028: An additional 15 drugs from both Part D and Part B will be selected.
• For 2029 and beyond: An additional 20 drugs from Part D and Part B will be selected each year.

By understanding this schedule, you can see that this program is designed for long-term savings and will expand to cover more high-cost medications over the next decade.

Other Important Cost-Saving Changes for Medicare Beneficiaries

The Inflation Reduction Act introduced several other protections to help lower your healthcare costs, some of which are already in effect or will be soon.

• Capped Insulin Costs: As of 2023, the monthly cost for a supply of insulin covered by Medicare Part D is capped at $35.
• Free Recommended Vaccines: Adult vaccines recommended by the Advisory Committee on Immunization Practices, like the shingles vaccine, are now available at no cost to you.
• Annual Out-of-Pocket Cap: Starting in 2025, there will be a new $2,000 annual cap on what you have to pay out-of-pocket for prescription drugs covered under Medicare Part D. This is a major change that will provide significant financial protection for those with high drug costs.

These provisions, combined with the new drug price negotiations, represent some of the most substantial updates to Medicare in years, all aimed at making healthcare more affordable.

Frequently Asked Questions

What if my drug isn’t on the first list? If your medication is not one of the first 10, it doesn’t mean you won’t see savings in the future. CMS will select more drugs for negotiation in the coming years. Keep an eye on official announcements from Medicare.gov to see if your drug is added in 2027 or beyond.

When will I know the final discounted price? The negotiation process between Medicare and the drug manufacturers is ongoing. The final negotiated prices for the first 10 drugs are expected to be published by CMS by September 1, 2024. The new prices will then take effect on January 1, 2026.

How does this affect my Medicare Advantage or Part D plan? All Medicare prescription drug plans, including standalone Part D plans and Medicare Advantage plans with drug coverage, will be required to offer the new, lower negotiated prices for the selected drugs. This ensures that everyone on Medicare has access to these savings, regardless of their specific plan choice.