As your local health insurance advisor, I always aim to keep you In The Know. With Medicare changes coming in 2026, it is important to prepare early, review your coverage, and understand how these shifts may affect your costs and options.
Below are the key updates to watch for this AEP (Annual Election Period).
Part B Premium Will Increase in 2026
The standard Medicare Part B premium is currently $185 per month for 2025. In 2026, it is projected to rise to $206.50 per month, which would be one of the largest single-year increases in recent years.
Part B is funded 25 percent by beneficiary premiums and 75 percent by general tax revenue. As overall healthcare costs rise, premiums tend to follow.
What to do: If you are on a fixed income or have other coverage options, we will review how this increase could affect your budget and help you plan accordingly.
Part D Out-of-Pocket Cap and Premium Changes
Beginning in 2025, the Inflation Reduction Act sets a $2,000 out-of-pocket cap for prescription drugs covered under Part D. This is good news for those with high medication costs.
However, the cap is expected to lead to higher Part D premiums and deductibles starting in 2026. Here are the projected figures:
- Average base premium: approximately $38.99 per month
- Deductible: approximately $615
- Out-of-pocket maximum: approximately $2,100
What to do: During AEP, we will review your prescriptions, check plan formularies, and compare available options to balance cost and coverage.
Medicare Advantage Plans Under Review
Medicare Advantage plans are facing new pressure. The federal government is increasing oversight related to risk coding and billing practices. In response, some insurance companies are discontinuing certain plans or cutting benefits.
If your current plan is being discontinued or significantly changed, you will need to select a new option for 2026.
What to do: Do not assume your plan will stay the same. I will help you explore all available plans and decide if a Medicare Supplement plus Part D may be a better fit.
Reduced Subsidies for Part D in 2026
To stabilize premiums in 2025, the government provided extra funding to Part D plans. That support will be reduced by about 40 percent for 2026. This may lead to increased premiums, stricter formularies, or changes in coverage.
What to do: Be prepared to re-evaluate your current plan. What works in 2025 may not offer the same value next year.
How I Can Help
The Annual Election Period runs from October 15 to December 7, but preparation starts now. As your agent, I can:
- Review your Annual Notice of Change
- Update your prescription list and providers
- Clarify new rules and coverage details
Let’s Stay In The Know
At ITK Insurance, my mission is to help you make smart, confident choices about your healthcare coverage. Whether you are already on Medicare or turning 65 soon, you deserve clear guidance and dependable support.
Call or text today to schedule your Medicare review for 2026. Appointments will fill quickly.
Stay covered. Stay informed. Stay In The Know.