As of February 2026, over 56 million individuals are enrolled in Medicare Part D, a significant outpatient prescription drug benefit offered through various private plans. This program includes Medicare Advantage plans that provide Part D coverage (MA-PDs) and stand-alone prescription drug plans (PDPs) for those in traditional Medicare. The latest data from the Centers for Medicare & Medicaid Services (CMS) reveals that the enrollment landscape is shifting, with notable trends impacting how beneficiaries access their prescription drug benefits.
Out of the total 56.1 million enrollees, 56% (approximately 31.3 million) are part of MA-PDs, whereas 44% (24.9 million) are enrolled in stand-alone PDPs. This marks a continuation of the trend favoring Medicare Advantage over traditional Medicare options. The data indicates that while enrollment in non-group MA-PDs has seen an increase, the growth in enrollment for non-group PDPs has stabilized yet still recorded modest gains.
From February 2025 to February 2026, enrollment in non-group MA-PDs grew by 1 million, while non-group PDP enrollment increased by half a million. This growth in MA-PDs reflects beneficiaries’ continued preference for comprehensive plans that include both medical and drug coverage. However, the average monthly premium for non-group PDPs decreased from $39 to $36 during the same period, presumably due to shifts towards lower-cost options.
Trends in Employer Group Plans
Interestingly, the landscape of employer group plans has also shifted. For the first time since 2010, enrollment in group MA-PDs declined, dropping from 3.9 million to 2.7 million. In contrast, there was a significant increase in enrollment in group PDPs, which rose from 5.1 million to 6.3 million. This dual trend of decreasing enrollment in group MA-PDs coupled with increasing enrollment in group PDPs indicates a strategic pivot among employer groups, moving away from comprehensive plans to those that separate medical and drug benefits.
Factors Driving Enrollment Changes
The increase in group PDP enrollment could be attributed to employers adopting plans that allow them to maximize federal premium subsidies. This strategy enables groups to take advantage of the Part D premium stabilization demonstration, which offers a $10 per member per month premium subsidy for participating PDPs. Employers may find it financially advantageous to contract separately for medical benefits and drug benefits.
Competitive Landscape for PDPs
In the competitive landscape of Part D plans, Humana and Centene have emerged as significant players. Humana’s PDP enrollment surged by 61%, growing from 2.3 million to 3.7 million, while Centene’s enrollment increased by 11%, from 7.8 million to 8.7 million. These increases can be attributed to reductions in premiums for many of their plans, making them more appealing to both current beneficiaries and recent enrollees. Many national PDPs have introduced premiums below $10, providing beneficiaries with cost-effective options for maintaining drug coverage.
Despite the competitive advantages, some plans like CVS Health and UnitedHealth Group faced challenges, experiencing declines or modest increases in enrollment, respectively. The average premiums across these plans remain higher than those of Humana and Centene, reflecting a diverse market where beneficiaries are increasingly price-sensitive when selecting their plans.
Conclusion: What Lies Ahead
The evolving Medicare Part D enrollment landscape suggests a pivotal moment for beneficiaries and providers alike. As enrollment trends continue to shift, particularly among employer-sponsored plans, stakeholders must pay close attention to emerging patterns in plan offerings and pricing strategies. The ongoing adjustments in premiums and plan structures will likely influence beneficiary choices in the months to come.
For beneficiaries, it’s crucial to stay informed about these changes, as they may affect access to necessary medications. We encourage readers to share their thoughts on these changes and engage in discussions about Medicare Part D options.
