October 15th through December 7th is Medicare Open Enrollment. Most years there are some changes that need to be addressed, so you are prepared for the new year. For 2026, some changes I have read are negotiated prices for some high-cost drugs, higher Part B and D Premiums, slight increasing in the Part D out of pocket maximum and changes to Medicare Advantage plans. Also, the annual out of pocket cap for Part D is increasing from $2,000 to $2,100. So, Let’s talk about that.
- Negotiated Drug Prices: Medicare is going to negotiate the first set of 10 high-cost drugs. The drugs will have lower prices leading to an estimated 1.5 billion in annual out of pocket savings for beneficiaries and 6 billion in savings for the Medicare Program.
- Part D Deductible and out of pocket cap: The maximum Part D deductible is going from $590 to $615 with the annual out of pocket maximum increasing from $2,000 to $2,100.
- Part D Premiums: The average Part D premiums are projected to increase but will vary by plan and regain. There are however supposed to be more plan options available in 2026.
- Medicare Advantage Plans: Available Medicare advantage plans are expected to increase in 2026 with individuals having access to at least one plan suited for their needs and area.
- Reduced Average Premiums: The average monthly premium for Medicare advantage plans is expected to decrease in 2026, but individual plan premiums and benefits will again vary.
- Extra Benefits: Some Medicare advantage plans may reduce extra perks, so if you are one to take advantage of those perks, be sure to review the new plan details if there are any in open enrollment.
- Medicare Part B: There are changes projected for Medicare Part B in 2026 also. The new price of $206.50 per month is an increase of $21.50 from 2025, which is a 11.6% rise with higher income individuals seeing the surcharge (RMAA) projected to rise to $288.00.
- Social Security cost of having Adjustment: The latest update predicts the COLA will be a 2.8% increase which would boost the average social security payment for retirees by about $54.00. This would cover the increase Part B premium of $21.00.
I bring these points up because it is important to review what your new social security payment and Medicare costs are projected to be in the new year. Most Medicare plans send members an annual notice by the end of September each year. It should explain revisions to benefits, costs, covered drugs and very important network providers. If you have not received yours, be sure to call and request one.
I hear clients often say, “I’m just going to stay with the plan I have.” But I cannot stress enough the importance of at least making a phone call to see if there are any changes to the plan. There are usually representatives in your communities that are knowledgeable in the Medicare area. My wife and I have ours scheduled for the end of the month. Our plan that will no longer be offered in 2026. Take advantage of this open enrollment to make sure the plan you have is in place and still the right plan for your needs in 2026.