Medicare 2026_What you should know.
Medicare Options _ Major Changes
Signing up for Medicare Options for 2026 will be very stressful and tricky this year. The government has made some major mandates, especially with the Prescription Drug Plan. The maximum out of pocket has been changed to $2100 a year limit. No more Part D ‘donut hole” or coverage gap. Deductibles are higher and placed on lower tier drugs! The Part D prescription drug deductible is set by the federal government. In 2025 the amount was $590. In 2026 it will increase to $615.
Consequently, all the major insurers providing Medicare Advantage with Prescription Drug Plans included, along with the stand-alone Prescription Drug carriers are making major changes to many of their coverages. In many instances, companies are completely pulling out of markets!
Take your time to look at all of your options, and there are many. Each carrier offers just a different approach to managing your healthcare. You need to determine your personal situation and with the help of a licensed certified agent, get your questions answered. Do not be pressured into making a decision unless you are comfortable with the program. Remember, you have until the end of Medicare Open Enrollment to make your final decision.
Finally, let’s look at the predicted cost of Medicare Part A and Part B:
Medicare Part B Premium for 2026
Projected Premium Increase
The standard monthly premium for Medicare Part B is expected to rise significantly in 2026.
- 2025 Premium: $185.00
- 2026 Projected Premium: $206.50
- Percentage Increase: Approximately 11.6%
Deductibles and Other Costs
Along with the premium increase, the annual deductible for Part B is also projected to rise:
- 2025 Deductible: $257.00
- 2026 Projected Deductible: $288.00
- Percentage Increase: 12%
Before you speak with someone, let’s look at some of the considerations:
- Your current health. This is a key component for the options you choose.
- The complete list of your current medications and prescriptions.
- Your financial ability to meet copays, out-of-pocket expenses, and maximum liability.
- Look for eligibility of government help.
- Check to see what Insurance Networks your Doctors, Hospitals, Providers, and Pharmacies are part of.
- Specific programs for Veterans, Chronic Illness, Medicaid/low-income situations, and more.
Let’s look at your options:
- Stay with the U.S. Government Medicare Program Directly. This option needs a stand-alone Rx Drug Card that needs to fit your current list of prescriptions.
- Choose a Medicare Supplement to help with the out-of-pocket cost inherent in Medicare.
- Medi-Share Healthshare can also be used as a substitute for Med-Supps. It has been around a long time and can provide a less expensive option.
- Choose a Program offered by an Insurance Company that will be managing your healthcare. These are referred to MAPD (Medicare Advantage Prescription Drug Plans). With these plans, you must be aware of the healthcare networks being offered, the copays, the deductibles, and the out-of-pocket maximum. Most MAPD plans offer other added benefits that are not available with standard Medicare.
Other information you should be aware of would be the requirement that over-the-phone presentations need to be recorded. Do not let that scare you. The idea is to protect you, the consumer from any conflicts that may arise during your sign-up and decision. Remember, the CHOICE is always yours. Take your time and choose the plan that fits your needs and that you are comfortable with.
See the downloadable attachments in below to have a better understanding of Medicare.
If you live in New York State, feel free to call 315 622-7000 or email me at [email protected]. Let me know the best time to reach you and we can discuss the programs available for you and answer all of your questions. If my line is busy, please leave a message and I will call you back. You will always speak to me, Art.
