Wondering about 2026 and Brinsupri coverage especially for someone like me who will get Part D for the first time in order to get Brinsupri. Found this information for what it is worth:

There appears to be confusion regarding Brinsupri coverage in 2026, stemming from the fact that it is currently being obtained through Part D while its newness creates uncertainty for future formulary decisions. AI models that analyze drug data may also flag issues with coverage, but this may not account for real-time negotiations.
Here is a breakdown of why this discrepancy is happening:
Negotiations are in progress. Brinsupri was only approved by the FDA in August 2025. The manufacturer, Insmed, is currently in the process of negotiating coverage with various insurance providers, including those that offer Medicare Part D plans.
Formulary placement is not guaranteed. A Part D plan's list of covered drugs (the formulary) changes annually. While a plan might offer an exception or cover the drug now, it does not guarantee Brinsupri will be on its standard formulary in 2026. A drug's inclusion is a complex process that considers price, effectiveness, and the number of existing alternatives.

Current patients may have temporary access. The reason some people are getting Brinsupri now through Part D is likely due to an exceptions process, which allows for coverage of a drug not on the standard formulary. For 2026, those same patients will likely need a new exception, and coverage will depend on the terms of their specific plan for that year.
The $2,100 out-of-pocket cap for 2026 is relevant. For high-cost medications, the Inflation Reduction Act's new $2,100 cap on annual out-of-pocket costs for covered drugs can provide significant relief to patients. However, this cap only applies to drugs that are on the plan's formulary, and the high cost of Brinsupri may influence how or if plans add it.
What to do for 2026 coverage
Check your specific Part D plan. During the upcoming Open Enrollment Period (October 15 – December 7, 2025), you should review the 2026 formulary for your specific plan. Your plan should provide you with an Annual Notice of Change (ANOC) that details what drugs will be covered.
Consider alternative plans. If your current plan will not cover Brinsupri in 2026, you may need to switch to a different Part D or Medicare Advantage plan that does.
Consult a professional. A benefits counselor or pharmacist can help you compare plans and understand your options for coverage in the new year.