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Medicare Prescription Drug Costs: Part D, Advantage Plan Squeezes, and Canada Importation

Mike Roth and Bill Kadereit discuss how retirees on Original Medicare buy standalone Part D plans from private insurers and how rising prescription costs have driven a 2026 “plan squeeze,” with 2.6 million Medicare Advantage plans discontinued and only 360 plans nationwide (down 29% from 2025). They cite premium shocks (e.g., Cigna rising from $37 to $91) and an IBM retiree example where a bundled plan was replaced by a separate $160 drug premium. They review Inflation Reduction Act provisions including a $2,100 Part D out-of-pocket cap, limited Medicare drug price negotiations (10 drugs, with 15 more for 2027), and a $35/month insulin cap. They note FDA enforcement discretion allowing personal importation from Canada up to 90 days, plus Florida’s 2024 authorization, and highlight pending bills such as S 641 and the Stop Stalling Act, while pointing to NRLN resources and upcoming episodes on enrollment and “guarantee issue” rights after plan terminations.

00:00 Prescription Costs Overview
01:05 Part D Plans and 2026 Squeeze
02:33 Premium Shock Stories
03:37 IRA Cap and Negotiations
04:30 Buying Drugs in Canada
06:44 Most Favored Nation Pricing
08:04 Rebates and Middlemen
09:35 Discount Cards and Import Rules
11:45 Drug Price Hikes and Bills
16:11 NLRN Resources and Action Alerts
17:08 Next Episode Enrollment Rights
20:24 Wrap Up and Where to Listen