Medicare Part D Enrollment: MA-PDs Lead, PDPs See Shifts in 2026

As of early 2026, the landscape of Medicare Part D prescription drug coverage continues to evolve, with notable shifts in enrollment patterns between traditional stand-alone plans and those bundled with Medicare Advantage. Recent data from the Centers for Medicare & Medicaid Services (CMS) reveals that 56.1 million beneficiaries are enrolled in Part D, with a growing proportion opting for Medicare Advantage plans that include drug coverage (MA-PDs). This trend reflects a broader movement toward Medicare Advantage though some captivating countercurrents are emerging, particularly within employer-sponsored group plans.

A Shifting Balance in Part D Enrollment

Currently, more than half of Part D enrollees – 56%, or 31.3 million people – are in MA-PDs, while the remaining 44% utilize stand-alone prescription drug plans (PDPs). While overall MA-PD enrollment experienced a slight dip between February 2025 and February 2026, from 31.4 million to 31.3 million, growth in non-group MA-PDs still outpaced growth in PDPs (1 million versus 0.5 million, respectively). This suggests continued interest in the integrated benefits offered by Medicare Advantage, despite some fluctuations. You can find more information about Medicare Advantage enrollment trends here.

Interestingly, the average monthly premium for stand-alone PDPs has decreased, falling from $39 to $36 between February 2025 and February 2026. This is likely due to increased competition and the availability of lower-premium options, prompting some beneficiaries to shift from higher-cost plans. However, the number of PDP options available to beneficiaries has continued to decline, dropping from an average of 14 in 2025 to 11 in 2026.

Employer-Sponsored Plans Show a Divergent Trend

A significant change is occurring within employer-sponsored group plans. For the first time since 2010, enrollment in group MA-PDs decreased – by 1.2 million – while enrollment in group PDPs increased by the same amount. This represents the largest year-over-year increase in employer group PDP enrollment since 2013. This shift may be linked to a strategic move by some employers and unions to separate medical and prescription drug benefits, contracting with Medicare Advantage plans for medical coverage and stand-alone PDPs for drug coverage.

This strategy could allow groups to take advantage of the Part D premium stabilization demonstration, which provides a $10 per member per month premium subsidy to PDPs that participate – a subsidy not available to MA-PDs. The demonstration aims to lower drug costs for beneficiaries by encouraging competition among PDPs.

Plan Performance and Enrollment Shifts

Several national PDPs are offering premiums below $10 in many regions for 2026, providing beneficiaries with affordable options for prescription drug coverage. However, some plans have also increased premiums, up to the maximum allowed $50 increase for plans participating in the premium stabilization demonstration.

Humana and Centene (WellCare PDPs) experienced the largest increases in PDP enrollment between February 2025 and February 2026, likely due to reducing monthly premiums and offering low or zero-premium options in several regions. Humana’s PDP enrollment increased by 61% (1.4 million), while Centene’s increased by 11% (0.9 million). Both companies also have lower average enrollment-weighted premiums across their PDP offerings compared to 2025. Conversely, CVS Health and Health Care Service Corporation saw declines in PDP enrollment, while UnitedHealth Group experienced only a modest increase. You can read more about premium changes in Medicare Part D here.

Understanding Special Needs Plans (SNPs)

It’s also important to note the role of Special Needs Plans (SNPs) within Medicare Advantage. SNPs are designed for individuals with specific chronic conditions or dual eligibility for Medicare and Medicaid. Enrollment in SNPs has been a key driver of overall Medicare Advantage growth, and these plans continue to attract beneficiaries seeking tailored care and benefits. A closer look at SNPs can be found here.

Implications and What to Expect

These enrollment shifts suggest that beneficiaries are increasingly sensitive to premium costs and are actively seeking out the most affordable options for prescription drug coverage. The availability of lower-premium PDPs, coupled with the potential for premium subsidies through the Part D premium stabilization demonstration, is likely driving this trend. The changes in employer-sponsored plans indicate a strategic response to the evolving Part D landscape, with some employers opting to separate medical and drug benefits to maximize cost savings and access to subsidies.

CMS continues to monitor these trends and is proposing changes to Medicare Advantage payment policies to address concerns about overpayment and ensure the long-term sustainability of the program. The Medicare Rights Center provides analysis of these proposed changes here.

Beneficiaries are encouraged to carefully review their Part D options each year during the open enrollment period and to consider their individual prescription drug needs and preferences when making a decision. Resources are available through Medicare.gov and through State Health Insurance Assistance Programs (SHIPs) to assist beneficiaries navigate the complexities of Part D and choose the plan that best meets their needs.