What’s Changing in 2026

What’s Changing in 2026

💰 1. Premiums and Costs

• Medicare is paying more plans in 2026

• Average monthly Medicare Advantage premiums are expected to stay low or go down slightly

• Your costs may still change depending on your plan and location

What to do: Always check your plan’s yearly notice for cost changes.

🏥 2. Stronger Protections for Hospital Care

• If your plan approves a hospital stay, it can’t get that approval back later, except in rare cases

• Clearer rules for denials and appeals

Why this matters: Fewer surprise coverage problems when you need care.

🩺 3. Doctor and Hospital Lists Must Be More Accurate

• Plans must keep up-to-date provider lists

• Medicare’s Plan Finder tool will have better information

What to do: Still confirm your doctors are in-network before enrolling.

🎁 4. Changes to Extra (Supplemental) Benefits

• Extra benefits must help improve or maintain your health

• Some non-medical items may no longer be offered

• Popular benefits like dental, vision, hearing, meals, and transportation usually remain

💊 5. Prescription Drug Coverage

• Some high-cost drugs will have lower prices in 2026

• Drug lists (formularies) and copays may change

What to do: Make sure your medications are covered at a cost you can afford.

🤝 6. Improvements for People with Medicare and Medicaid

If you have both:

• Better coordination between Medicare and Medicaid

• Plans will work toward simpler ID cards and care coordination

📅 When You Can Make Changes

• Annual Enrollment: October 15 – December 7

• Medicare Advantage Open Enrollment: January 1 – March 31 (if already in an MA plan)

Quick Checklist Before Choosing a Plan

✅Are my doctors and hospitals covered?
✅Are my prescriptions covered and affordable?
✅What is the yearly out-of-pocket maximum?
✅Do I use the extra benefits offered?
✅Is this plan still the best fit for my health needs?