Medicare Part D Plan Changes 2026: Why WV Drug Plans Are Disappearing and How to Respond

Medicare Part D plan changes 2026 are shaking up the prescription drug landscape across West Virginia. Many stand-alone Part D plans are consolidating, merging, or exiting the market entirely. These shifts stem from the major 2025–2026 Part D redesign that changed how plans, Medicare, and drug manufacturers share costs. The result? Fewer plan choices, changing formularies, and new ways to manage drug expenses — but also better protection through a $2,100 annual out-of-pocket cap in 2026.

What’s Changing with Medicare Part D Plan Changes 2026

• Fewer Part D plan options: Most West Virginia counties will see only 8–12 stand-alone PDP choices in 2026, down from nearly 30 a few years ago.
• Annual out-of-pocket cap: In 2026, once your total drug costs reach $2,100, you pay $0 for covered Part D drugs the rest of the year.
• Rising deductibles: The maximum deductible allowed under Medicare Part D is $615 in 2026.
• Pharmacy network changes: Many plans are limiting preferred pharmacies to control costs.

Why Medicare Part D Plans Are Changing for 2026

1. Redesign shifted liability. The 2025–2026 Medicare Part D plan changes reduced Medicare’s share of catastrophic spending and increased plan and manufacturer liability. Plans are consolidating to balance those costs.
2. Premium stabilization pressures. Because CMS limited premium growth, insurers are trimming benefits or leaving less-profitable regions.
3. Consolidation among carriers. National companies are merging multiple PDPs into one streamlined plan to reduce overhead and risk.
4. Impact of drug price negotiations. As negotiated drug prices begin in 2026, plans are tightening formularies to offset price uncertainty.

How Medicare Part D Plan Changes 2026 Affect West Virginia Residents

People in Beckley, Raleigh County, and throughout southern West Virginia may notice their current prescription drug plan is disappearing or automatically crosswalked to a different option. That’s why it’s crucial to review your Annual Notice of Change each September and compare new plan options during AEP. If you have a Medicare Supplement (Medigap), remember you don’t change that policy — you only update your stand-alone Part D plan each year.

What You Can Do About Medicare Part D Plan Changes 2026

1. Review your ANOC letter for any changes in premium, deductible, and drug coverage.
2. Make a complete drug and pharmacy list and use Medicare.gov’s Plan Finder to see which plan covers your prescriptions at the lowest total cost.
3. Watch for Special Enrollment Periods if your plan is discontinued or you’re moved into a new one you don’t like.
4. Check for Extra Help eligibility since 2025 rules expanded subsidies for low-income beneficiaries.
5. Ask about the Prescription Payment Plan to spread high drug costs over 12 monthly payments.

Original Medicare + Part D vs. Medicare Advantage in 2026

How Songer Insurance in Beckley Can Help

• We provide free 2026 Part D plan comparisons based on your exact prescriptions and preferred pharmacies.
• We verify tier placement, preferred pharmacy status, and any prior authorization requirements.
• If your plan is ending, we’ll guide you through a Special Enrollment Period to avoid coverage gaps.
• We also help screen for Extra Help (LIS) to reduce drug costs.

Call: 304-252-2158  |  Visit: 330 Harper Park, Beckley, WV 25801

Internal Links

• West Virginia Medicare Part D Prescription Drug Plans
• Medicare Supplement Plans WV
• Contact Songer Insurance

Helpful Resources

• Medicare & You 2026 Handbook
• CMS 2026 Part D Redesign Fact Sheet
• KFF: Current Snapshot of Medicare Part D