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 options are becoming particularly sparse for shoppers with low-income subsidies who want to pay no premium. Plus, help may be harder to find as some big insurers no longer pay brokers commissions for new business. Shoppers have just a few weeks starting October 15 to sort out coverage for next year.