Making Medicare Part D More Affordable for Patients

The Issue

Medicare patients in the Part D prescription drug program often face significant out-of-pocket costs, especially early in the year while trying to meet their deductible. Changes to the Medicare Part D program could help.

In 2026, Medicare will cap out-of-pocket expenses for Part D medications at $2,100 per patient, per year. No patient will pay more than $2,100 out of pocket in combined expenses for all their medications during a single year.

In addition, patients who previously enrolled in the Medicare Prescription Payment Plan will be automatically re-enrolled during open enrollment, unless they change prescription drug plans. The program may help make prescription drug costs more manageable.

Patients who are not already enrolled can opt in during the open enrollment period, beginning October 15, 2025, or at any point that’s convenient for them. Learn more about the Medicare Prescription Payment Plan to decide if enrolling is the right decision.

Resources

Blogs

State Updates

Below is a list of current legislation that supports patients with serious mental illness. 

 

Arizona

SB 1083                                                                                     HB 2449

Read the bill       Contact your legislator                          Read the bill       Contact your legislator


Colorado

SB 24-110 

Read the bill       Contact your legislator


Florida

SB 268                                                                                       HB 491

Read the bill       Contact your legislator                        Read the bill      Contact your legislator


Georgia

HB 1179

Read the bill       Contact your legislator


Illinois

SB 1636                                                                                       HB 2456

Read the bill       Contact your legislator                            Read the bill       Contact your legislator


Maryland

SB 990                                                                                        HB 1423

Read the bill       Contact your legislator                            Read the bill       Contact your legislator

 

Massachusetts

H 989                                                                                           S 631 

Read the bill       Contact your legislator                            Read the bill       Contact your legislator


New Jersey

S 1192 

Read the bill       Contact your legislator


North Carolina

HB 680 

Read the bill       Contact your legislator


Wisconsin

SB 618                                                                                          AB 654 

Read the bill       Contact your legislator                            Read the bill       Contact your legislator

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