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:

Here's who needs a Medicare Part D plan

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

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