2026 Medicare Part D Plans in New York State - with changes from 2025

The Annual Enrollment Period ("AEP" or "open enrollment") for Medicare Part D and Medicare Advantage plans for 2026 runs from October 15 through December 7, 2025.    

For 2025 plan lists - click here.   Read below for 2026 plan lists. 

Every year, you should review your plan options to see if your current plan still meets your needs - see more here on what to look for in the CMS Planfinder. Click here for How to use Medicare Plan Finder, step-by-step - by CMS.

2026 changes -

• Out of Pocket Limit increased to $2100  -  This limit began in 2025 at $2000, greatly reducing  maximum out of pocket costs for consumers, as enacted in the Investment Recovery Act (IRA).  See A Current Snapshot of the Medicare Part D Prescription Drug Benefit (Kaiser Family Foundation)... (updated Oct. 2025). Unfortunately, many plans are increasing drug costs and premiums, claiming this is because of this $2000 annual limit.

• See other 2026 changes in Medicare Advantage and Part D - summary by AARP here  

• Center for Medicare Advocacy  webinar about 2026 Open Enrollment here  and

• Medicare Rights Center Guide to Medicare Open Enrollment fro 2026  and Six things to know 

• Justice in Aging’s updated Open Enrollment resource provides information advocates for older adults need to know about this year’s open enrollment periods.   It covers recent changes to the Medicare Plan Finder, details about programs that help with Medicare costs, and provides practical tips on assisting clients in choosing the best coverage for their needs. The resource also emphasizes how to help ensure people are not overpaying for their health and prescription drug coverage.

Part D Cost-Sharing Chart - Download from NCOA here (2025 chart will be updated for 2026 soon)

• Medicare Rights Center Cost-sharing information about Part D (2025 info - will be updated soon for 2026)

2024 "Extra Help" Expansion - read here and read about other 2024 changes here

2024-25 CMS Guide to Consumer Mailings - Notices sent about plan closings, reassignments, Extra Help.

2026 Part D and Medicare Advantage plans - from CMS lists posted here 

1.  Stand Alone Part D Prescription Drug Plans (PDP) -  (PDF)(Excel) (10 plans (down from 12 in 2025  in New York State for people in Original Medicare. Chart shows the 2026 premium and the 2025 premium for comparison, and the 2026 premium for those with Full Extra Help.   Stay tuned for updated chart with Star Ratings. 

   • TWO (2) "BENCHMARK" STAND-ALONE PDP PLANS have a FREE PREMIUM for people with FULL "EXTRA HELP" (Low Income Subsidy) - this chart shows changes from 2025.  This is down from three "benchmark" plans in 2025.  

     • The two benchmark plans are HealthSpring Assurance Rx  (formerly Cigna Assurance) and Wellcare Classic.

     • SilverScript Choice (Aetna) is no longer a benchmark plan.  Members of this plan who have Extra Help will be charged a premium of $57.20 if they remain in the plan in 2026.  For those without Extra Help, the premium will be $116.  See this chart that explains the options for those with Extra Help.

   • Benchmark Premium is $58.82 in 2025, down from $72.34 in 2025.

   • People enrolled in Extra Help, either because they were approved for Medicaid or a Medicare Savings Program or because they applied to the SSA for Extra Help, are assigned to a benchmark plan if they don't pick one themselves and enroll.

     • People with Extra Help who enroll in a plan other than the 2 "benchmark plans" pay a reduced premium, shown on the chart.

   • Two stand-alone Prescription drug plans  (PDP) are closing  in 2026  --  Wellcare Medicare Rx Value Plus and CIGNA Rx. See more info in charts.

   • Lowest premium for a stand-alone plan (for those without Extra Help) is $35.70 (Healthspring Assurance Rx)(Formerly Cigna Assurance Rx) and the highest is $173.60 (Humana Premier Rx Plan).

   • Premiums for four of the 10 plans increased by $50 in 2026.  This is reportedly due to plans seeking to reduce their costs resulting from the $2000/year out of pocket limit.

   • See q1medicare.com for more info on plan changes 2026

2. Medicare Advantage (MA and MA-PD) 2026 Plans in NYS -   -- NOTE THAT MANY insurers scaling back MA plan offerings. See Kiplingers report, and this Spectrum News report about several insurance companies closing MA-PD plans in western New York in 2026.

• CMS reports that the average monthly Medicare Advantage plan premium changed from $39.59 in 2025  to $40.49 in 2026.

  • 218 Medicare Advantage plans are available in 2026, compared to 241 plans in 2025 (per CMS, unclear if this includes SNPs).  
   

3. NYS Special Needs Plans (SNP)  2026 (SNP)  -  has separate tab for each of the 3 basic types of  SNPs - ]

   1. DUAL-SNP for Dual Eligibles  (D-SNP) (further broken down by "HIDE, FIDE, or CO SNP 

      • FIDE SNPS are the only ones that are "aligned" with a Medicaid Advantage Plus plan that combines MLTC with a Medicare Advantage plan.  List has a column showing which MAP plans are aligned with the D-SNP.  See more here   about MAP plans.

      • HIDE status is required for plan to be aligned with an IB-Dual plan - Integrated Benefit for Duals plan - Medicaid plan for dual eliigibles who don't need long term care

      • See more here about who is "default enrolled" into FIDE and HIDE SNPS and their "aligned" MAP or IB-Dual plans. 

      • Also see this list of Integrated D-SNP plans for Dual Eligibles in NYS, with the aligned MAP or IB-DUAL plan.

   2. Chronic condtion SNP
   3. Institutional SNP

Helpful information about \ Medicare Part D -

• INSULIN - $35 CAP started in 2023!!! 

  The $35 Insulin Senior Savings Model, which began in 2021 and extended into 2022, changed in 2023. Starting 2023, insulin has a copay price cap at $35 for a one-month supply as long as it is a brand APPROVED/COVERED by your Medicare Part D insurance plan, including during your deductible period and donut hole.  You can find more information here on the Medicare government website.

• National Council on Aging (NCOA): What is Medicare and How Do I Get Started?

• National Council on Aging (NCOA): How to Choose a Medicare Plan During Open Enrollment

• What to review ever year - because plans change and your drug needs change

  • Are your prescriptions on the plan's formulary (which may change year to year), in the dosage and strength that you take? Are there new "utilization review" limits such as quantity limits or prior approval requirements?  

  • Have premium, deductible, and coinsurance costs increased?   

  • If you are in a Medicare Advantage plan, are your preferred doctors and other providers in network, and have the costs increased? (coinsurance, deductible, premium) 

  • See more Questions to Ask when Comparing Part D Plans

The lists posted here are extracted from nationwide charts on the CMS website at http://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn/. Sanctioned plans are also available at that link. Some extra information was added to the above charts by NYLAG, including some comparisons from 2024 plans, sourced from 2024 chart and q1Medicare.com.

2025 Plan Lists

1. Stand Alone Part D Prescription Drug Plans (PDP) -  (PDF) 

2. Medicare Advantage (MA) 2025 Plans in NYA (MA-PD) -   --1st tab is Statewide list by county, followed by separate tabs for NYC MA plan and statewide list ofSpecial Needs Plans (SNP).  Also see changes from 2024 in your county on q1Medicare.com (source for some info added to this chart).

   • 280 MA plans in NYS in 2025, up from 241 plans in 2024.

   • The popular Excellus Medicare Blue Choice Access (PPO) closed, which was in Monroe, Ontario, Seneca, Wayne & Yates  counties.   Excellus launched  a new PPO Medicare Blue Choice Discovery in those counties, and a new Univera SeniorChoice Core (PPO) in Erie and seven other upstate counties.  

3. NYS Special Needs Plans 2025  (SNP)  - (Third tab) Will be updated to show which plans are affiliated with a Medicaid Advantage Plus plan (also known as FIDE for Fully Integrated Dual Eligible).  See more about "default enrollment" into SNPs here

4. Medicare Advantage (MA) Plans (MA-PD) - (Excel) offered in NYS -  Also see changes from 2024 in your county on q1Medicare.com (source for some info added to this chart).

5. NYS Special Needs Plans (SNP) - (Excel) showing which plans are affiliated with a Medicaid Advantage Plus plan (also known as FIDE for Fully Integrated Dual Eligible).