Important Medicare Changes Coming in 2026 – What You Need to Prepare For

Every year, Medicare makes adjustments—but the 2026 changes are forecasted to be bigger than usual and could have a real impact on your health and your wallet. This fall’s open enrollment (October 15–December 7) is especially important to review carefully.

 

Here are some of the biggest updates you should know:

  • Higher Premiums & Deductibles – Medicare Part B premiums are projected to rise over 11%, and prescription drug (Part D) deductibles will also increase. These increases can add up quickly for those on a fixed income.
  • Prescription Drug Relief – The first group of Medicare-negotiated drug prices goes into effect in 2026, which should mean savings on some high-cost medications, including insulin. The new insulin rules could lower costs even more.
  • Medicare Advantage Plan Changes – Many Advantage plans are reducing “extra perks” and may add new prior-authorization requirements. That means you’ll want to look closely at the coverage details—not just the extras.
  • Medicaid & Dual-Eligible Changes – If you qualify for both Medicare and Medicaid, new rules could affect your coverage and access to important benefits like dental and vision care.

Forecasted Medicare Cost Increases for 2026

2025 projected cost

2026 projected cost

Percent Increase

Part B premium

$185

$206.50

11.6%

Part D base beneficiary premium

$36.78

$38.99

6%

Part B deductible

$257

$288

12%

Part D deductible

$590

$615

4.2%

Part D catastrophic threshold

$2,000

$2,100

5%

 

What this means for you: don’t assume your current plan will still be the best fit in 2026. The details matter, and small changes can affect your coverage, your doctors, and your costs.

You can navigate forthcoming changes to Medicare—and your health insurance—by taking these steps. 

  • Avoid blindly re-enrolling in your current plan,  as it can change significantly year to year. You may feel very loyal to your plan, but then suddenly find out that its provider network has shrunk and your doctor is no longer included. Confirm that your plan still offers the best coverage for your area and budget compared to alternatives. 
  • Read the list of covered medications in Part D plans carefully.  These lists are called formularies.   Medicare Part D plans and pharmacy benefit managers (PBMs) may need to re-evaluate their formularies and pricing strategies, in light of negotiated drug prices. As a result, it’s essential to check if the medication you’re taking is covered before joining or renewing a plan in 2026. 
  • Seek assistance.  Work with a Medicare insurance broker, such as myself. As an independent broker (one who doesn’t just work for one insurance company) I can help you understand your options, particularly if you’re considering a switch from Medicare Advantage to Original Medicare plus a Medigap plan.

📅 Remember, open enrollment starts October 15—but with these upcoming changes, it’s smart to start planning now.

 

Sound overwhelming? It can be. That’s why I strongly encourage you to set up a complementary Medicare consultation session with me . Together, we can review your plan, look at your prescriptions, and make sure you’re in the right place for 2026 and beyond. To schedule your complimentary session, just give me a call, send me an email, or access my on-line calendar to schedule a 1 on 1 review session.

 

I’m here to help you make Medicare simple and stress-free.