CMS Releases Key Part D Data for Plan Year 2026 (PY 2026)
CMS Releases Key Part D Data for Plan Year 2026 (PY 2026)
Written by Chalen Jackson
JULY 28, 2025 — CMS released the much anticipated National Average Monthly Bid Amount (NAMBA), and other key Medicare Part D metrics (click here to view the original CMS article). Both can provide insight to the way the Part D program is shaping up this year. While not a direct line of sight, we can get a feel for how the market may look going into next year as plans take this information and go into the re-bid process for the next two weeks.
NAMBA is an enrollment-weighted average monthly bid by plans for their anticipated cost to insure a Medicare Beneficiary on Part D. Please note that this is across all Part D bids, including benefits embedded in Medicare Advantage (MA) plans. For Plan Year 2026 (PY 2026), the NAMBA is $239.27, a significant increase from 2025’s $179.45. Plans are expecting to spend more next year in caring for beneficiaries.
The Base Beneficiary Premium (BBP) factors significantly to what plans actually get paid by CMS, and for beneficiaries represents their risk with Late Enrollment Penalties (LEP). The Part D LEP is 1% of the BBP for each month they went without creditable coverage. The Inflation Reduction Act (IRA) capped the annual increase in the BBP to 6%. Predictably, the 2026 BBP is $38.99—a 6% increase from last year. Under the proper actuarial formula, the BBP should be $75.38, representing a rapidly widening gap between statutory prices and reality.
Another huge factor in this year’s data is a change to the Part D Premium Stabilization Demonstration. CMS has renewed the program with changes. For PY 2026, plans that participate will have to agree to raise premiums by no more than $50 ($35 for PY 2025). In exchange, they will receive a reduction in the BBP of $10 ($15 for PY 2025), but will NOT receive narrowed risk corridors as they did in PY 2025. This represents an intentional shift towards less intervention in the market price of Part D coverage.
Lastly, CMS released supplemental data for Employer Group Waiver Plans, Low Income Subsidy amounts, and other required releases relating to Part D. Plans have two weeks to allocate rebates and file final plan bids!
If you would like to learn more about what all these numbers mean for your market and how to prepare for AEP, reach out to our team!
About Chalen Jackson
As a Key Accounts Specialist and Compliance Officer with Senior Marketing Specialists, Chalen works with top-performing agents and agencies to establish and execute strategic growth programs to help them reach the next level of their success. Chalen ensures that agents are in the know on compliance and regulatory changes as well as developing tools to help them remain effective in the current oversight environment.
You can find Chalen’s work in national industry publications and as a sought-after speaker at events around the country, working to educate agents on how to grow their business no matter what regulatory hurdles may pop up.
Chalen currently serves as the President of Missouri NABIP and on the National Medicare Advisory Group for NABIP.
For more information, please call us today at (800) 689-2800 or send us an email at contact@smsteam.net!
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