On September 26, the Centers for Medicare and Medicaid Services (CMS) released the 2026 Medicare Advantage (MA) and Part D landscape files. These data provide the first view into MA and Part D plan offerings and premiums for 2026, highlighting continued shifts to the Part D market under the Inflation Reduction Act (IRA).   

Background  

Significant changes to the Part D benefit have occurred under the IRA. In 2025, plan liability increased in the benefit with the removal of the coverage gap, implementation of the $2,000 out-of-pocket cap, and shift in the benefit structure for low-income subsidy (LIS) enrollees. Beginning in 2026, the law also implements Maximum Fair Prices (MFPs) for the first set of selected drugs under the Medicare Drug Price Negotiation Program. Part D plan bids for Calendar Year (CY) 2026 indicate that plans are likely still adjusting to the redesigned benefit, while also responding to changes in drug and medical utilization trends, MA policy updates, and potential shifts in strategy driven by new MFP dynamics between negotiated drugs and non-negotiated competitor products.  

Plan Premiums 

On July 28, CMS announced modifications to the voluntary Part D Premium Stabilization Demonstration for standalone Prescription Drug Plans (PDPs) for 2026, which will reduce subsidies to limit premium increases for participating plans. While the PDP premium demonstration and the premium stabilization program under the IRA have mitigated some premium increases to date, PDP premiums are increasing substantially in 2026.  

For non-LIS beneficiaries, Avalere Health estimates that enrollment-weighted average PDP premiums will increase by 32% for plans offered in both 2025 and 2026. Enrollment-weighted average PDP premiums will increase slightly more for non-LIS enrollees in basic plans (36% increase) compared to enhanced plans (31% increase) (Table 1).   

Table 1: Enrollment-weighted Average PDP Premiums for Non-LIS Enrollees by Plan Type, 2025 vs. 2026 

Although CMS did not release data on which plan sponsors are participating in the PDP Premium Stabilization Demonstration, the agency noted that nearly all PDP beneficiaries are currently in a plan that opted into the demonstration for 2026. 

Due to the disproportionate impact of the premium stabilization programs on different plan types, not all enrollees will experience the same change in premiums. Among non-LIS beneficiaries in PDPs, 25% of enrollees are in plans that will have a premium increase of $30 or more in 2026, while 17% are in plans that will have a premium change of less than $1. Similar to 2025, 74% of non-LIS Medicare Advantage Prescription Drug Plan (MA-PD) enrollees are currently in a non-Special Needs Plan (non-SNP) MA-PD with a $0 Part D premium that will remain at $0 in 2026. However, 16% of MA-PD beneficiaries are in a plan that will have a Part D premium increase of $10 or more in 2026. 

Part D Plan Offerings   

Part D market dynamics under the IRA, along with broader Medicare market shifts continue to affect the availability of plan options, particularly for standalone PDPs. For 2026, the number of PDPs is decreasing by 22%, falling from 464 plans in 2025 to 360 plans in 2026. This follows a 35% reduction in PDP offerings from 2024 to 2025. The number of non-SNP MA-PDs is declining by 9%, from 3,246 MA-PDs in 2025 to 2,967 in 2026 (Figure 1). 

Figure 1. Number of Part D Plans by Plan Type, 2024–2026 

Note: MA-PD numbers exclude SNPs, MA plans without drug coverage, Medicare-Medicaid Plans (MMPs), Program of All-Inclusive Care for the Elderly (PACE) plans, Cost Plans, Medicare Medical Savings Account (MSA), and Private Fee-for-Service (PFFS) plans.

Despite the reduced number of non-SNP MA-PDs, the number of SNPs is increasing by 20%, highlighting how changes in plan offerings varies by plan type, plan sponsor, and region. In 2026, one larger plan sponsor is exiting the PDP market, while many other sponsors are reducing or eliminating enhanced PDP options. Overall, the number of enhanced PDPs is declining by 34% in 2026, following a 40% reduction from 2024 to 2025. The number of enhanced MA-PDs is also decreasing by 9%.

Low-Income Subsidy Benchmark Plan Availability

Following major reductions in the number of LIS benchmark plans in recent years—including a 34% reduction in 2024 and a 29% reduction in 2025—the number of available LIS benchmark plans will decrease slightly in 2026, from 90 plans in 2025 to 88 plans in 2026.

In 2026, beneficiaries in all states will have no more than four LIS benchmark plans options, and beneficiaries in 20 states and DC will have only two or fewer benchmark plans.

Potential Effects on Beneficiary Access

In the coming weeks, CMS will release the 2026 Part D formulary files, which will provide insight into how plans are continuing to adjust their formularies in response to the first year Part D redesign and introduction of MFPs. Taken together, broader Medicare market and policy changes, reduced plan offerings, premium changes, and evolving formulary management strategies could reshape the choices available to beneficiaries and alter access and affordability.  Stakeholders should consider how the evolving Part D market landscape—including the combined effects of changes in plan offerings, premiums, and formularies—will influence competitive positioning and affect patient populations differently across regions and plan types.

For more information on how plan availability, premiums, and formularies for 2026 and beyond will impact your organization, connect with us.

Methodology

Avalere Health used the Landscape files released by CMS in September 2023–2025. PDP data for 2025 reflect numbers from CMS’s landscape file update in October 2024. Except where noted, Employer Group Waiver Plans, SNPs, MMPs, PACE plans, Cost Plans, MSAs, PFFs plans, and plans in US territories are excluded from this analysis. For calculations of enrollment-weighted average premiums, Avalere Health used enrollment data from September 2025 and assumed no beneficiaries will change plans for 2026. Enrollment-weighted average premium estimates only include plans that will be available in both 2025 and 2026. Enrollment-weighted average premium estimates reflect only non-LIS enrollees who pay the full plan premium. LIS enrollment in each plan was therefore excluded for this estimate using the 2025 LIS enrollment file. For estimates reflecting LIS enrollees, Avalere Health derived LIS enrollment at the state level by using the Plan level Part D enrollment file for PDP, Contract-Plan-State-County level Part D enrollment file for MA-PD, and the LIS plan level enrollment file released by CMS in 2025.