Medicare Premium Changes in 2026: What You Need to Know

Every year, Medicare Advantage plans change. That’s because they’re based on one-year contracts with private insurance companies, which means plans can renew, modify, or even cancel at the end of each year. In 2024, nearly 1.9 million people lost their plans because contracts weren’t renewed, and we expect similar shifts in both 2025 and 2026. If you’re on a Medicare Advantage plan, you need to be prepared because these changes can directly affect your coverage, your costs, and even which doctors you can see.

Let’s start with the big picture. In 2026, some plans will be dropped altogether. That means if your plan is discontinued, you’ll have to pick a new one. Even if your plan continues, networks may change so the doctor or hospital you use now might not be included next year. Financially, we’re seeing costs creep up across the board. Premiums that were once $0 could climb to $15 or $30 per month. Deductibles, co-pays, and co-insurance may increase too. And while extras like dental, vision, and hearing will still exist, they’re likely to become more restrictive. For example, dental coverage might range anywhere from $1,000 to $3,000 but often with tighter limits than before.

Prescription drug coverage is another area where changes are coming. Every year, you need to check if your medications are still covered on your plan’s formulary and if their tier classification has shifted. A higher tier means a higher cost. Some expensive drugs may even be dropped altogether, forcing beneficiaries to switch plans to stay covered. In 2026, the catastrophic cap for out-of-pocket medication costs will increase from $2,000 to $2,100. After you hit that limit, your drugs will be fully covered. Deductibles are rising too from $590 in 2025 to $615 in 2026 for both standalone Part D plans and drug coverage within Advantage plans.

There is some good news on the horizon. The prior authorization process is being improved. Starting in 2026, non-urgent requests will have to be reviewed within 7 days instead of 14, helping reduce delays. Insurance carriers will also be required to publicly report approval rates and give clearer explanations when requests are denied. Plus, if you switch carriers, prior authorizations approved within the last 90 days must be honored by your new plan, ensuring continuity of care.

The key step for every Medicare Advantage beneficiary is to carefully review the Annual Notice of Change (ANOC) letter. These letters will arrive between mid-September and October 15th and will explain exactly what’s changing with your plan or if your plan is being canceled altogether. From October 15th to December 7th, you’ll have the chance to switch plans during the annual enrollment period. Whatever choice you make will go into effect on January 1st, 2026.

I can’t stress this enough: don’t ignore your ANOC letter. This is the single best way to stay ahead of changes and avoid being surprised come January. If you’re unsure how to compare your options, that’s where we can help. My colleague Erica Smiley and our team at MedicareSchool.com specialize in walking people through these decisions. You can schedule an appointment with us to get personalized guidance and make sure you’re not just covered but fully protected for 2026.

We’ve also created resources, including videos where I break down ANOC letters and explain these changes step by step, so you can feel confident about your Medicare decisions.

The bottom line? Medicare Advantage in 2026 will bring higher costs, stricter benefits, and shifting networks. But with the right preparation—reviewing your ANOC, comparing your options, and seeking expert advice you can navigate the changes and make sure your healthcare needs are met.