Fewer choices may be on the menu again as Medicare patients shop for prescription coverage this fall.
The number of available, stand-alone drug plans has fallen for a few years, and that trend will continue for 2026. Most markets will still have several choices, but some options are becoming particularly sparse for shoppers with low-income subsidies. And help may be harder to find because some insurers no longer pay brokers commissions for new business.
Shoppers have from Oct. 15 to Dec. 7 to find new coverage that starts in January.
Some things to consider:
Regular Medicare, which most people qualify for after turning 65, does not come with prescription coverage, known as Part D. People must choose that separately.
About 23 million people with regular Medicare have this standalone coverage, according to the non-profit KFF, which studies health care.
Another roughly 34 million people have Medicare Advantage plans, which are privately run versions of Medicare that often come with prescription coverage.
A typical shopper will be able to choose a standalone drug plan from among eight to 12 options for 2026, according to KFF Medicare expert Juliette Cubanski. That’s down from 12 to 16 options in 2025.
Shoppers had nearly 30 choices as recently as 2021, according to the Commonwealth Fund’s Gretchen Jacobson.
Depending on the state, a range of one to four plans will be available at no premium to people who qualify for low-income subsidies, according to KFF. Eight were available in 2021.
Some insurers are reducing their presence in standalone Part D plans, while the Blue Cross-Blue Shield carrier Elevance is leaving the market entirely. Insurers and analysts who follow the industry note that the Inflation Reduction Act, which will cap annual out-of-pocket drug costs at $2,100 in 2026, puts more financial pressure on insurers. The same law now allows patients to spread the cost of prescriptions over the year.
Most markets will have several choices. But experts say Medicare Part D customers don’t like to shop, especially if they already have a plan that covers their medications. Finding affordable coverage for multiple prescriptions can be tricky.
“I think there’s a lot of inertia and, frankly, people may be concerned that if they switch, they’re going to end up worse off,” Cubanski said.
More people are being pushed to shop. Nearly 11% of those with standalone prescription drug coverage lost their plan in 2024, according to research published recently in the Journal of the American Medical Association.
Before 2023, that figure was often under 1%, said Dr. Christopher Cai, one of the researchers involved in the study.
Monthly premiums, or coverage prices, will fall nearly 10% on average to $34.50, the Centers for Medicare and Medicaid Services announced last month.
At least one option with a premium of under $20 exists in almost every region of the country, according to the consulting firm Oliver Wyman.
Individual prices will range widely, with premiums for the same plan varying by state, Cubanski noted.
But while plans may provide lower coverage prices, they could also raise deductibles or offer more limited lists of covered drugs, which are called formularies. Shoppers should check these details.
Insurers will be allowed to raise premiums by as much as $50 a month for 2026, up from a $35 increase allowed this year. But Cubanski said only some plans will hit that higher limit and not necessarily in all states.
Shoppers can use a federal government website to compare plan prices and coverage.
States also have a State Health Insurance Program created specifically to help people on Medicare find coverage.
Consumers can help themselves by checking their coverage for changes and comparing it with other plans.
Shoppers also should consider whether their pharmacy is in the network covered by any plan they are considering, said Jacobson, Commonwealth’s vice president of Medicare.
Some might also consider switching to Medicare Advantage plans with prescription coverage. But those plans can have more limited networks of covered doctors, which can pose a problem for people with fewer care choices in rural areas.
The enrollment window spans several weeks, but brokers say many people wait until that first week in December to make decisions, often after talking with family during holiday dinners.
That can create a deadline crunch that makes it harder to find help in early December.
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
FILE - Bottles of medicine ride on a conveyor belt at a mail-in pharmacy warehouse in Florence, N.J., on July 10, 2018. (AP Photo/Julio Cortez, File)
BEIJING (AP) — In China, the names of things are often either ornately poetic or jarringly direct. A new, wildly popular app among young Chinese people is definitively the latter.
It's called, simply, “Are You Dead?"
In a vast country whose young people are increasingly on the move, the new, one-button app — which has taken the country by digital storm this month — is essentially exactly what it says it is. People who live alone in far-off cities and may be at risk — or just perceived as such by friends or relatives — can push an outsized green circle on their phone screens and send proof of life over the network to a friend or loved one. The cost: 8 yuan (about $1.10).
It's simple and straightforward — essentially a 21st-century Chinese digital version of those American pendants with an alert button on them for senior citizens that gave birth to the famed TV commercial: “I've fallen, and I can't get up!”
Developed by three young people in their 20s, “Are You Dead?” became the most downloaded paid app on the Apple App Store in China last week, according to local media reports. It is also becoming a top download in places as diverse as Singapore and the Netherlands, Britain and India and the United States — in line with the developers' attitude that loneliness and safety aren't just Chinese issues.
“Every country has young people who move to big cities to chase their dreams,” Ian Lü, 29, one of the app's developers, said Thursday.
Lü, who worked and lived alone in the southern city of Shenzhen for five years, experienced such loneliness himself. He said the need for a frictionless check-in is especially strong among introverts. “It's unrealistic,” he said, “to message people every day just to tell them you're still alive.”
Against the backdrop of modern and increasingly frenetic Chinese life, the market for the app is understandable.
Traditionally, Chinese families have tended to live together or at least in close proximity across generations — something embedded deep in the nation's culture until recent years. That has changed in the last few decades with urbanization and rapid economic growth that have sent many Chinese to join what is effectively a diaspora within their own nation — and taken hundreds of millions far from parents, grandparents, aunts and uncles.
Today, the country has more than 100 million households with only one person, according to an annual report from the National Bureau of Statistics of China in 2024.
Consider Chen Xingyu, 32, who has lived on her own for years in Kunming, the capital of southern China’s Yunnan province. “It is new and funny. The name ’Are You Dead?' is very interesting,” Chen said.
Chen, a “lying flat” practitioner who has rejected the grueling, fast-paced career of many in her age group, would try the app but worries about data security. “Assuming many who want to try are women users, if information of such detail about users gets leaked, that’d be terrible,” she said.
Yuan Sangsang, a Shanghai designer, has been living on her own for a decade and describes herself as a “single cow and horse.” She's not hoping the app will save her life — only help her relatives in the event that she does, in fact, expire alone.
"I just don’t want to die with no dignity, like the body gets rotten and smelly before it is found," said Yuan, 38. “That would be unfair for the ones who have to deal with it.”
While such an app might at first seem best suited to elderly people — regardless of their smartphone literacy — all reports indicate that “Are You Dead?” is being snapped up by younger people as the wry equivalent of a social media check-in.
“Some netizens say that the 'Are you dead?' greeting feels like a carefree joke between close friends — both heartfelt and gives a sense of unguarded ease,” the business website Yicai, the Chinese Business Network, said in a commentary. ""It likely explains why so many young people unanimously like this app."
The commentary, by writer He Tao, went further in analyzing the cultural landscape. He wrote that the app's immediate success “serves as a darkly humorous social metaphor, reminding us to pay attention to the living conditions and inner world of contemporary young people. Those who downloaded it clearly need more than just a functional security measure; they crave a signal of being seen and understood.”
Death is a taboo subject in Chinese culture, and the word itself is shunned to the point where many buildings in China have no fourth floor because the word for “four” and the word for “death” sound the same — “si.” Lü acknowledged that the app's name sparked public pressure.
“Death is an issue every one of us has to face,” he said. “Only when you truly understand death do you start thinking about how long you can exist in this world, and how you want to realize the value of your life.”
A few days ago, though, the developers said on their official account on China’s Weibo social platform that they’d pivot to a new name. Their choice: the more cryptic “Demumu,” which they said they hoped could "serve more solo dwellers globally.”
Then, a twist: Late Wednesday, the app team posted on its Weibo account that workshopping the name Demumu didn’t turn out “as well as expected.” The app team is offering a reward for whoever offers a new name that will be picked this weekend. Lü said more than 10,000 people have weighed in.
The reward for the new moniker: $96 — or, in China, 666 yuan.
Fu Ting reported from Washington. AP researcher Shihuan Chen in Beijing contributed.
The app Are You Dead? is seen on a smartphone in Beijing, China, Thursday, Jan. 15, 2026. (AP Photo/Ng Han Guan)
A woman looks at her smartphone in a cafe in Beijing, China, Thursday, Jan. 15, 2026. (AP Photo/Ng Han Guan)
A woman looks at her smartphone outside a restaurant in Beijing, China, Thursday, Jan. 15, 2026. (AP Photo/Ng Han Guan)
A man looks down near his smartphone in Beijing, China, Thursday, Jan. 15, 2026. (AP Photo/Ng Han Guan)
A man reacts while holding his smartphone in Beijing, China, Thursday, Jan. 15, 2026. (AP Photo/Ng Han Guan)
