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3 DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, MD 21244-1850

OFFICE OF THE ACTUARY

DATE: July 28, 2025 TO: All Medicare Advantage Organizations and Medicare Prescription Drug Plan Sponsors FROM: Jennifer Lazio, Director, Parts C & D Actuarial Group

SUBJECT: Annual Release of Part D National Average Monthly Bid Amount and other Part C & D Bid Related Information

Today we are releasing the Calendar Year (CY) 2026 Part D national average monthly bid amount, the Medicare Part D base beneficiary premium, the Part D regional low-income premium subsidy amounts, the Medicare Advantage (MA) regional PPO benchmarks, the MA employer group waiver plan (EGWP) regional payment rates, and the Part D calendar year EGWP prospective reinsurance amount. Below we describe the determination of these amounts. The regional low-income premium subsidy amounts and the regional MA benchmarks can be downloaded from the CMS web site at: https://www.cms.gov/files/document/regional-rates-and-benchmarks-2026.pdf.

Part D National Average Monthly Bid Amount CMS has calculated the national average monthly bid amount for CY 2026 in accordance with section 1860D-13(a)(4) of the Social Security Act (“the Act”), codified in 42 CFR § 423.279. For each coverage year, CMS computes the national average monthly bid amount from the applicable Part D plan bid submissions in order to calculate the base beneficiary premium, as provided in 42 CFR § 423.286(c). Because the national average monthly bid amount is calculated based on plans’ standardized bid amounts, it is not impacted by the voluntary Part D Premium Stabilization Demonstration for standalone prescription drug plans (PDPs). The national average monthly bid amount is a weighted average of the standardized bid amounts for each PDP and MA plan with prescription drug coverage (MA-PD) described in section 1851(a)(2)(A)(i) of the Act. The weights are based on the number of enrollees in each plan. The weight for each plan bid is a percentage calculated with the numerator equal to the number of Part D eligible individuals enrolled in the plan in the reference month (as defined in 42 CFR § 422.258(c)(1)) and the denominator equal to the total number of Part D eligible individuals enrolled in the reference month in all applicable Part D plans. Per section 1860D-13(a)(4)(A) of the Act, the calculation does not include Part D bids submitted by Medicare Medical Savings Account (MSA) plans, MA private fee-for-service plans, specialized MA plans for special needs