Your Guide to Medicare's 2026 Prescription Drug Discounts

If you’re on Medicare, you may have heard whispers about big changes coming to prescription drug prices. For the first time, Medicare is negotiating lower costs for certain high-cost drugs, and those savings are set to begin in 2026. We’ll walk you through what’s happening and how to see if your medications are included.

Understanding the New Medicare Drug Price Negotiations

The changes you’re hearing about are part of the Inflation Reduction Act of 2022. This law gave Medicare the power to directly negotiate drug prices with manufacturers, a major shift aimed at making essential medications more affordable for millions of seniors.

Before this law, Medicare was generally prohibited from negotiating drug prices. The new program allows the Centers for Medicare & Medicaid Services (CMS) to select a certain number of expensive drugs each year for negotiation. The process takes time, with negotiations happening now for prices that will take effect on January 1, 2026.

The goal is simple: to lower your out-of-pocket costs at the pharmacy for some of the most common and costly prescription drugs covered under Medicare Part D. This isn’t a new plan you have to sign up for. If you have a Medicare prescription drug plan (Part D) and take one of the selected drugs, you will automatically benefit from the lower price once it goes into effect.

The First 10 Drugs Selected for Lower Prices in 2026

The most important question for many is, “Is my medication on the list?” In August 2023, CMS announced the first 10 drugs that will have newly negotiated prices starting in 2026. These medications were chosen because they account for a significant portion of Medicare spending and are taken by millions of beneficiaries.

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

Eliquis (Apixaban): A blood thinner 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 shown to reduce the risk of cardiovascular death in adults with heart disease.
Xarelto (Rivaroxaban): Another common blood thinner used to treat and prevent blood clots.
Januvia (Sitagliptin): A medication used to help control blood sugar levels in adults with type 2 diabetes.
Farxiga (Dapagliflozin): Used to treat 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): An injectable biologic drug used to treat rheumatoid arthritis and other autoimmune conditions like psoriasis and psoriatic arthritis.
Imbruvica (Ibrutinib): A cancer medication used to treat certain types of blood cancers, including mantle cell lymphoma and chronic lymphocytic leukemia.
Stelara (Ustekinumab): Used to treat several autoimmune disorders, including psoriasis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis.
Fiasp; Fiasp FlexTouch; Fiasp PenFill; Novolog; Novolog FlexPen; Novolog PenFill (Insulin Aspart): A fast-acting insulin product used to manage blood sugar levels in people with type 1 and type 2 diabetes.

If you take any of these medications, you are likely to see a reduction in your out-of-pocket costs starting in 2026.

How to Check if Your Medications Will Be Discounted

The ad promised to show you how to check if your medications are included, and it’s a straightforward process. Here is your step-by-step guide to staying informed.

Step 1: Compare Your Prescription List to the Current List

The simplest first step is to look at the list of 10 drugs provided above. Get your prescription bottles or a list from your pharmacy and see if any of the brand names match. If you take one of these drugs, you are on track to see savings in 2026.

Step 2: Understand This Is Just the Beginning

It is very important to know that this list of 10 drugs is only for the first year. The program is designed to expand over time. More drugs will be selected for negotiation in the coming years:

For 2027: An additional 15 drugs will be selected.
For 2028: Another 15 drugs will be added.
For 2029 and beyond: 20 new drugs will be added each year.

This means that even if your medication isn’t on the first list, it could be selected in a future year.

Step 3: Check Official Government Sources for Updates

The most reliable place for information is directly from the source. To find the most current and accurate list of negotiated drugs, you can visit the official websites for Medicare or the U.S. Department of Health and Human Services (HHS). Look for sections related to the “Inflation Reduction Act” or “Medicare Drug Price Negotiation.” These government sites will always have the latest news and updated lists as they become available.

Step 4: Talk to Your Doctor or Pharmacist

Your healthcare team is your best resource. Your doctor or pharmacist can confirm if a medication you take is on the list. They can also discuss whether a generic version might become available or if there are other cost-saving alternatives for you. When new lists are announced in future years, they can help you review them.

Other Important Medicare Cost Savings

The Inflation Reduction Act introduced several other valuable benefits that are already helping or will soon help beneficiaries save money. These are separate from the 2026 price negotiations.

$35 Monthly Cap on Insulin: As of 2023, Medicare beneficiaries with Part D pay no more than $35 for a one-month supply of covered insulin products.
Free Recommended Vaccines: Vaccines recommended for adults by the CDC, such as the shingles vaccine (Shingrix), are now available at no cost to people with Medicare Part D.
$2,000 Out-of-Pocket Cap (Coming in 2025): Starting in 2025, there will be an annual cap of $2,000 on what you have to pay out-of-pocket for prescription drugs under Part D. This will provide significant financial protection for those with very high drug costs.

Staying informed about these changes can help you better manage your healthcare budget and get the full benefits of your Medicare coverage.

Frequently Asked Questions

When will I actually see the lower prices for the first 10 drugs? The newly negotiated prices for the first 10 drugs will officially take effect on January 1, 2026.

How much money will I save on these drugs? The exact amount of savings is not yet known. The negotiation process between Medicare and the drug manufacturers is ongoing. The final negotiated prices are scheduled to be published by September 1, 2024. However, the program is expected to result in significant price reductions.

Do I need to sign up or apply for these discounts? No. If you are enrolled in a Medicare Part D plan and your prescribed medication is on the negotiation list, the lower price will be applied automatically when you fill your prescription at the pharmacy, starting in 2026.

What if I take a generic version of one of these drugs? The negotiation program primarily targets brand-name drugs that do not have significant generic competition. If you are already taking a lower-cost generic, these specific negotiations may not directly affect your copay, but the overall effort to lower drug costs can have positive effects across the market.