For caregivers, helping a loved one review their Medicare prescription coverage is one of the most practical ways to support their health.
With major changes coming to Medicare Part D in 2026, this year’s open enrollment period — Oct. 15 through Dec. 7 — is especially important. Medicare Part D helps older adults afford the medications they rely on, including treatments for high blood pressure, cholesterol, diabetes, arthritis, pain management, and heart health.
Understanding what’s changing can help you protect their well-being and budget. Below are answers to common caregiver questions to guide you through the process.
1. Why is it important for me to help the person I care for review Medicare Part D this year?
Medication needs often change and so do Part D plans.
Even if your loved one’s 2025 plan worked well, changes for 2026 may affect their access to medications or their monthly costs.
Caregivers can help ensure their loved one stays protected and avoids surprise pharmacy bills in January.
Related: Know your numbers – Help older adults stay informed about key health indicators.
2. What are the major Medicare Part D changes for 2026?
In 2026:
- Out-of-pocket drug costs are capped at $2,100.
- The new Medicare Prescription Payment Plan (MPPP) will allow monthly payments instead of large upfront pharmacy bills.
- Some high-cost drugs will have Medicare-negotiated prices.
These changes can make budgeting more predictable. This helps reduce cost barriers for ongoing medications.
3. How does the new MPPP help the person I care for?
The new payment plan spreads Part D costs across monthly installments, making budgeting easier, especially after unexpected hospital visits or new prescriptions.
This gives you and the person you care for peace of mind.
4. What information should I have before comparing plans?
Have the following ready:
- A list of all prescription medications the person you care for takes
- Their Medicare card
- Their current Part D plan name
- Preferred pharmacies
- The Annual Notice of Change (mailed in early fall)
This helps ensure accurate plan comparisons.
5. How do we compare Medicare plans?
Use the Medicare plan finder to:
- Enter medications.
- Compare pharmacy prices.
- Review drug coverage.
- See if a plan participates in the new monthly payment program.
- Estimate total yearly costs.
6. What should the person I care for focus on when choosing a plan?
Look closely at:
- Whether all medications are covered
- Whether any new restrictions (like prior authorization) apply
- Copays and deductibles
- Total annual cost — not just the premium
- Whether your loved one’s pharmacy is preferred
This prevents unexpected price increases.
7. What if they say they’re fine with their current plan?
Reassure them:
“It might still be a great fit. Let’s just double-check your medications are still covered for 2026.”
Plan details change every year, so reviewing coverage helps avoid disruptions.
9. What should I do after they choose a Part D plan?
In January 2026:
- Notify the pharmacy.
- Verify automatic refills.
- Make sure doctors’ offices have up-to-date insurance information.
- If applicable, confirm the plan’s mail-order pharmacy (if applicable).
A quick check prevents refill delays early in the year.
10. Where can we get free Medicare help?
You can get support from:
- State Health Insurance Assistance Programs (SHIP): Free one-on-one counseling from trained Medicare experts.
- 1-800-MEDICARE (1-800-633-4227) for 24/7 support. TTY: 1-877-486-2048. Or start a live chat online.
- Extra Help program (for low-income assistance): Helps with premiums, deductibles, and drug copays.
Your Support Makes a Difference
Navigating Medicare Part D can feel overwhelming. But your involvement helps ensure the person you care for maintains access to the medications that support their health, safety, and independence.
By reviewing their coverage before Dec. 7, you’re helping them:
- Stay on track with important prescriptions.
- Avoid sudden changes in cost or coverage.
- Take full advantage of the new 2026 affordability features.
Your support makes a real difference, and reviewing coverage now is one of the most meaningful ways to help your loved one stay well in the year ahead.
