Your Guide to Medicare's 2026 Prescription Drug Discounts

If you’re on Medicare, you may have heard talk about big changes coming to prescription drug costs. It’s true. Thanks to new legislation, the price of certain common medications is set to decrease. This guide will explain exactly what is happening, list the first drugs with negotiated prices, and show you how to check if your medications are included.

Understanding the New Medicare Drug Price Negotiations

For years, the cost of prescription drugs has been a major concern for many seniors. The good news is that a law called the Inflation Reduction Act of 2022 gave Medicare the power to do something it could never do before: negotiate directly with drug companies to lower the prices of some of the most expensive prescription medications.

This negotiation process is a landmark change. It means that for certain high-cost drugs covered under Medicare Part D, the price you pay could be significantly lower. The process is being rolled out in phases over the next several years, with the first negotiated prices taking effect in 2026. Each year, Medicare will select more drugs for negotiation, expanding the potential for savings.

The goal is simple: to make essential medications more affordable and to reduce out-of-pocket spending for millions of people on Medicare.

The First 10 Drugs with Lower Prices in 2026

The Centers for Medicare & Medicaid Services (CMS) has announced the first 10 drugs selected for price negotiation. The new, lower prices for these specific medications will become effective on January 1, 2026. If you take any of the following drugs, you are likely to see savings.

Here is the list of the first 10 drugs, along with what they are commonly used to treat:

  • 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 has also been approved for certain types of heart failure.
  • 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, psoriatic arthritis, and other autoimmune conditions.
  • Imbruvica (Ibrutinib): A targeted therapy medication used to treat certain types of blood cancers, including mantle cell lymphoma and chronic lymphocytic leukemia.
  • Stelara (Ustekinumab): Used to treat psoriasis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis.
  • Fiasp; Fiasp FlexTouch; Fiasp PenFill; Novolog; Novolog FlexPen; Novolog PenFill (Insulin Aspart): These are different brand names for a fast-acting insulin used to manage blood sugar in people with type 1 and type 2 diabetes.

It is important to remember that this is just the beginning. More drugs will be added to the negotiation list in the coming years, bringing potential savings to an even wider range of patients.

How to Check if Your Medications Will Be Discounted

The ad you clicked promised to show you how to check if your medications are included in these new discounts. Here is a straightforward, step-by-step approach to staying informed.

Step 1: Review the Current List

The simplest first step is to carefully review the list of 10 drugs provided above. Compare it to the prescription medications you currently take. If one of your drugs is on this list, you can expect its price to be lower starting in 2026.

Step 2: Keep an Eye on Future Announcements

This program is expanding. Medicare will select and negotiate prices for more drugs in the future.

  • 15 more Part D drugs will be selected for negotiation with prices effective in 2027.
  • Another 15 Part D and Part B drugs will be selected for 2028.
  • 20 more Part D and Part B drugs will be selected for 2029 and each year after.

The most reliable place to find official information is directly from the source. You can visit the official Medicare website at Medicare.gov or the CMS website for updates on which drugs are being added to the negotiation program.

Step 3: Talk with Your Doctor or Pharmacist

Your healthcare providers are your best resource. When you have your next appointment, bring a list of your medications and ask your doctor about these changes. They can discuss whether your drugs are on the negotiation list or if there are alternative medications that might be more affordable for you. Your pharmacist is also an excellent source of information about drug costs and coverage.

Other Major Cost-Saving Changes for Medicare Beneficiaries

The drug price negotiation is just one part of a larger effort to lower healthcare costs. Here are two other critical changes that are already helping or will soon help Medicare beneficiaries save money:

  1. A Cap on Out-of-Pocket Drug Costs (Starting 2025): This is a very significant change. Starting in 2025, no one on Medicare Part D will have to pay more than $2,000 per year out-of-pocket for their prescription drugs. This annual cap will provide a crucial financial safety net for people who take expensive medications for conditions like cancer or rheumatoid arthritis.

  2. $35 Monthly Cap on Insulin (Already in Effect): For anyone on Medicare who uses insulin, out-of-pocket costs are now capped at $35 for a month’s supply. This has already provided immense financial relief to millions of Americans with diabetes.

These changes, combined with the new drug price negotiations, represent the most substantial improvements to Medicare prescription drug coverage in years.

Frequently Asked Questions

What if my drug is not on the first list? Don’t worry if your medication is not on the initial list of 10. Many more drugs will be selected for negotiation in the coming years. Continue to monitor official announcements from Medicare and discuss cost-saving options with your doctor.

Do these new prices apply to Medicare Advantage plans? Yes. These changes apply to all Medicare prescription drug plans, including standalone Part D plans and Medicare Advantage plans that include drug coverage (MA-PD). If you are enrolled in a Medicare Advantage plan, you will benefit from these new negotiated prices and cost-saving measures.

When will we know the exact new prices for the first 10 drugs? The negotiation process between Medicare and the drug manufacturers is ongoing. The final negotiated prices for the first 10 drugs are expected to be announced by September 2024, well before they take effect in 2026.