On July 28, 2025, the Centers for Medicare & Medicaid Services (CMS) published preliminary Medicare Part D bid information for contract year 2026. Updates include the 2026 national average monthly bid amount, 2026 base beneficiary premium, and changes to the Part D Premium Stabilization Program.
CMS’ Part D bid updates are highly anticipated, as they help Part D sponsors finalize their prescription drug plan (PDP) and Medicare Advantage (MA) offerings for the upcoming plan year. They can also give insurance agents like you a peek at what you, and your clients, can expect to see during the Medicare Annual Enrollment Period.
Based on the July 2025 Part D bid info, we encourage agents offering Medicare support to prepare for another year of premium increases and plan disruption. Let us explain…
The 2026 Medicare Part D NAMBA
CMS reports a 2026 national average monthly bid amount (NAMBA) of $239.27. This is a $59.82, or 33 percent, increase from the 2025 NAMBA of $179.45.
CMS reports a 2026 national average monthly bid amount (NAMBA) of $239.27.
This figure is an enrollment-weighted average of all applicable Part D plan bids for basic Part D benefits. In other words, NAMBA is the average estimated cost for Part D plan sponsors to provide a benefit package. Since it’s enrollment-weighted, the bids of plans that have higher enrollments have more impact on the average bid than the bids of plans with lower enrollments.
The NAMBA is not the average Part D premium policyholders pay; NAMBA factors into the monthly Part D premiums for the policyholder as well as the government subsidy that health plans receive.
The 2026 Base Beneficiary Premium for Medicare Part D
The Part D national base beneficiary premium for 2026 will be $38.99, according to CMS. This is a $2.21, or six percent, increase from the 2025 national base beneficiary premium of $36.78.
The 2026 national base beneficiary premium will be $38.99.
CMS calculates this figure using a certain formula and a percentage of the bids and reinsurance cost estimates submitted by certain Part D plans for the minimum level of required coverage (the “basic benefit”). The base beneficiary premium cannot increase by more than six percent a year due to a provision in the Inflation Reduction Act (IRA).
The 2026 national base beneficiary premium is not the average Part D premium policyholders pay. It is the starting point plans use to calculate their plan-specific monthly premiums and also helps determine the amount of monthly direct subsidy the Federal government pays to health plans and Part D sponsors.
Changes to the Part D Premium Stabilization Demonstration Program
With the Medicare Part D bid updates for 2026, CMS also announced changes to the government’s three-year voluntary Part D Premium Stabilization Program. NOTE: The Part D Premium Stabilization Demonstration Program applies only to stand-alone Part D plans and does NOT apply to MAPD.
Introduced in 2024, the program is currently in its first year. The three main elements of the program are:
- Participating plans reduce their base beneficiary premium by $15 for 2025, lowering the cost of their plan-specific premium. (If this causes the plan’s total premium to cost less than $0, it has a $0 premium.)
- Participating plans agree not to raise their plan-specific total premium by more than $35 in a calendar year.
- The government takes on more risk for potential losses among participating plans.
For the 2026 Premium Stabilization Program for Part D, CMS is changing the parameters by:
- Reducing the base beneficiary premium reduction to $10
- Increasing the plan-specific total premium increase limit to $50 in a calendar year
- Eliminating the narrowed risk corridor thresholds.
CMS reasons that “Part D plan sponsors have built experience and are better equipped to understand and predict how the IRA benefit changes will affect utilization and costs.”
The 2025 estimated average government subsidy to plans was $142.67. TD Cowen analysts state the direct subsidy for 2026 will be $200.28, a $57.61, or 40 percent, increase.
The Part D Premium Stabilization Demonstration Program by CMS is an important factor in Part D cost. It subsidizes Part D coverage for plans as they adjust to market conditions with IRA provisions in effect in order to keep premiums and options more stable for Medicare enrollees.
Why We Predict Higher Premiums & PDP Market Disruption for 2026
Both the NAMBA and base beneficiary premium are increasing for 2026. Additionally, CMS states they “approved some revised bids and, for the first time, rejected standalone PDP bids that failed to address concerns regarding significant year-over-year premium increases and that were also market outliers compared to similar plans in the same region.” Combine these facts with the government’s reduced support in the Part D stabilization program, and we believe the latest 2026 Part D bid news tells us three things:
- Plans are still adjusting to IRA benefit changes, especially the $2,000 out-of-pocket cap ($2,100 in 2026) and coverage gap phase elimination from 2025.
- Policyholders will pay more for Part D coverage in 2026 than they paid for it in 2025.
- We’ll continue to see more disruption in Medicare Part D.
The first two items are logical conclusions with the changes we discussed above, as well as previous years’ data. The third? Higher costs of benefits can lead to reduced benefits, which may lead to policyholders switching plans, and carriers terminating their plans in certain markets. Moreover, when CMS rejects a bid, it means the plan cannot be offered to consumers for the upcoming plan year. If that plan is currently offered and has enrollees, they will have to find a new plan for the next year.
Medicare Part D bid information gives plans the market overview they need to know to finalize their offerings for the upcoming plan year, but it’s public information that agents can take in too! We hope you better understand what CMS announced for Medicare Part D bid information for 2026 and what it means for the PDP market this OEP.
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