My Part D plan increased from $17.00 to $78.00 per month. How about yours?
Why?
Easy, a combination of government policies, drug prices and the increased use of prescription drugs.
- Inflation Reduction Act (IRA) Implementation & Cost Shift:
- Out-of-Pocket Cap: The IRA established a hard cap on annual out-of-pocket prescription drug costs, which will be $2,100 in 2026 (up from $2,000 in 2025). While this is great for beneficiaries with high drug costs, it means Part D plans and drug manufacturers must cover a much larger share of those high costs.
- Plan Liability: Plans are taking on a greater percentage of the total costs for beneficiaries with high drug spending (above the cap). To offset this significantly increased liability, some plans are raising premiums for all members.
- Reduction in Premium Stabilization Demonstration:
- The government introduced a temporary Part D Premium Stabilization Demonstration in 2025 to help plans adjust to the IRA changes and keep premium increases modest.
- For 2026, the level of government subsidy in this demonstration is smaller ($10 per month, down from $15 in 2025), and the maximum premium increase allowed for participating plans is higher (up to $50 per month, up from a $35 cap in 2025). This reduction in government support and higher cap means your plan has more room to increase its premium.
- Rising Cost of Drugs and Healthcare Inflation:
- The general cost of prescription drugs, especially specialty drugs like GLP-1 medications (for diabetes and weight loss), continues to climb. Insurers factor this increasing cost and utilization into their premium projections.
- Specific Plan Dynamics:
- Shifting Enrollment/Utilization: If your specific plan enrolled more members with high drug costs in the previous year, or if it paid out significantly more in claims than anticipated, the plan sponsor may raise the premium to recover those costs.
- Exiting the Market: Some insurers are scaling back their stand-alone Part D offerings, reducing competition and potentially leading to higher rates for remaining plans in some regions.
QUINNSCOMMENTARY 
“As you certainly know, all insurance reflects someone else paying for the benefits you receive
Insurance is simply paying another party to accept risk, on their behalf, that they do not want to be responsible for. Yes, if someone in the risk pool has catastrophic expenses, premiums must rise, that arithmetic. I would argue the larger the pool -single payer- is a better way to spread the cost. Yes, I understand that some single payer systems control costs by rationing care (long wait times for medical services.) That in and of itself doesn’t mean single payer systems are inherently bad, they are often underfunded. I lived in a country that had a $1 single payer plan, it was great- until the stock of medicines ran out and people died before receiving service. I have also been to countries with no universal health care and were refused entry to a private hospital and died enroute to a charity funded hospital. Each society must decide how to handle this and, more importantly, who pays.
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Don’t confuse single pay insurance with a national healthcare system
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“Don’t confuse single pay insurance with a national healthcare system”
Likewise, I encourage you to not confuse the point I was making about who pays the cost of healthcare with semantics 🙂
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You said single payor plans control costs by rationing. And that is not true. A system like in the UK may ration care or limit spending. A system like Medicare does not.
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“As you certainly know, all insurance reflects someone else paying for the benefits you receive
Insurance is simply paying another party to accept risk, on their behalf, that they do not want to be responsible for. Yes, if someone in the risk pool has catastrophic expenses, premiums must rise, that arithmetic. I would argue the larger the pool -single payer- is a better way to spread the cost. Yes, I understand that some single payer systems control costs by rationing care (long wait times for medical services.) That in and of itself doesn’t mean single payer systems are inherently bad, they are often underfunded. I lived in a country that had a $1 single payer plan, it was great- until the stock of medicines ran out and people died before receiving service. I have also been to countries with no universal health care and were refused entry to a private hospital and died enroute to a charity funded hospital. Each society must decide how they will handle healthcare, and more importantly, who pays.
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FYI, so far, the only year in which my medical expenses exceeded the premiums/contributions/reductions in wages I paid (ignoring the FICA-Med and income taxes which go to fund medical expenses of others) was in 2001 – and even in that year, my expenses were only slightly higher than the funds I caused to contributed to my employer sponsored health coverage.
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I do want to mention that the government, per the Inflation Reduction Act, is getting ready to cap the prices Medicare plans must pay on the 10 most frequently used name brand prescription drugs.
The 10 popular medications in the first round of price reductions:
If the lower drug prices had been in effect in 2023, Medicare would have saved an estimated $6 billion, or about 22 percent, on the 10 drugs. That includes rebates and other payments, CMS previously reported.
As we used to say, squeeze the balloon in one place and watch it pop out elsewhere. No doubt, Rx manufacturers are jacking up the prices they charge for everything not on the list – as a means to recover the lost revenues. And, those price increases are impacting those Americans, slightly over half, who have health coverage but don’t have the government fixing their Rx prices.
Only the idiots from the Biden Administration, and career government employees, think this is what “negotiation” looks like.
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you are right for sure
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Once upon a time I managed a small utility company. We covered 100% of employee premiums, both single and family coverage. Our annual deductibles were $100 single and $200 family. Our premiums were skyrocketing; therefore, I announced a deductible increase to $200/ $400, single and family respectively.
Wailing and gnashing of teeth ensued; employees contacted board members and vented their frustrations pouring out heart felt tales of imminent personal bankruptcy.
What I learned from that experience was that folks want the very best healthcare- as long as someone else pays for it.
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I frequently share the story of attending a roundtable of citizens in Cincinnati Ohio as part of the Health Care That Works for All Americans activity – funded by the Medicare Modernization Act of 2003.
At the table I was at, we had about 10 other people. And, we went around the table asking people what they wanted to see. And, I will never forget the lady sitting next to me, who was the last to speak, and poiting at me, she said: ‘I want the best health care insurance your money will buy.’
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As you certainly know, all insurance reflects someone else paying for the benefits you receive. If you are lucky you will be the one paying for what someone else needs and never collect a penny yourself. So, I hope i pay for someone other than myself.
Alas since going on Medicare that has not happened and we have incurred over $300,000 in bills for which we now pay in total over $2,000 a month including supplemental.
Any system will reflect its total costs for healthcare. It’s a matter of fairly allocating those costs. Current insurance certainly doesn’t do that.
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Sure.
Am I happy my health hasn’t resulted in significant medical expenses? Sure.
My problem isn’t that I spent so much money, it is that others expect me to spend even more than the cost to provide my own coverage in order to fund the cost of their coverage.
There is a big difference between everyone contributing their own estimated cost of coverage into one big pool, and the way funding is allocated – in the past, today, and, given the preferences of most Americans, tomorrow.
Again, Americans want the best coverage YOUR money will buy.
I have shouldered (caused to be contributed in contributions, reduced wages and taxes more, much more) than my own cost of coverage. However, most Americans are not interested in shouldering the actual cost of their own medical coverage – even if we were to group the risks.
$2,000 a month is $24,000 a year, which is noticeably less than the actual cost of Medicare Part A, Part B, Part D and a Medicare Supplement for two people. However, I am confident that you are making additional “contributions” through personal income taxes which, along with the rest of Americans who pay income taxes, fund 75% of Medicare Part B and Part D.
Remember, the government pays for NOTHING. All of Medicare funding is coming from taxpayers, taxpayers today (Medicare Part A FICA-MED), income tax payers today (Funding 75+% of Part B and Part D), and future taxpayers – to the extent we continue to run $2+ Trillion in annual deficits.
I’m sorry to hear that your medical expenses have exceeded whatever you and your employers contributed towards the cost of your employer sponsored coverage, and what you and your employers have contributed in taxes to fund Medicare Part A, and what you have paid in personal income taxes that have contributed significantly to fund Medicare Part B and Part D.
Here’ hoping for better health for you, your family, and all readers here.
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‘I want the best health care insurance your money will buy.’
Yes, as long as someone else pays, we want the very best 🙂
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