Some seniors will pay more in 2026. Check if you’re in the safe zone.
- Mary Manos Mitchem
- 16 minutes ago
- 2 min read
The Annual Election Period is over, but that doesn’t mean the story is finished.
For 2026, Medicare prescription drug coverage is changing in ways that look good on paper but feel uneven in real life.
Here’s the straight talk.
What Changed. And Why It’s Confusing
Yes, the government negotiated lower prices on 10 high-cost drugs.
Yes, that’s projected to save about $1.5 billion overall. But averages lie.
Many seniors are now seeing:
Higher deductibles before coverage kicks in
Coinsurance percentages instead of flat copays
Certain high-cost drugs removed from formularies entirely
So while the system saved money, some individuals are paying more at the pharmacy counter.
That’s not theory. That’s happening now.
The Weight-Loss Drug “Bridge Program”
Starting in July, a new bridge program will cap certain weight-loss drugs at $50 per month.
Sounds great.
Here’s the catch:
Limited eligibility
Not all insurers are participating
Not all drugs qualify
Translation. Some people get relief. Others fall straight through the cracks.
Why This Matters After Open Enrollment
A lot of seniors think:
“I chose my plan. I’m stuck.”
That’s not entirely true.
While you can’t redo open enrollment, you can:
Understand how your current plan actually treats your prescriptions
Identify exposure to deductibles and coinsurance
Watch for formulary changes that may hit mid-year
Prepare now for smarter decisions in the next enrollment cycle
This is where guidance matters more than brochures.
How Mary and Alexis at Manos Insurance Help
Mary Manos Mitchem and Alexis Mitchem do not sell plans and disappear.
They help Medicare-eligible seniors:
Decode why a prescription costs more this year than last
Understand whether a drug is subject to coinsurance or deductible rules
Spot formulary risks before refills become a surprise
Plan ahead so next open enrollment is proactive, not reactive
No hype. No panic. Just clarity.
The Bottom Line
2026 prescription drug changes created winners, losers, and a lot of confusion in between.
If your costs went down, great.
If they didn’t, ignoring it won’t help.
Understanding your coverage now is the only way to avoid getting blindsided later.
That’s the difference between having a policy and having an advocate."
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