Medicare Changes To Know As This Year’s Open Enrollment Period Begins

The Open Enrollment Period for 2026 Medicare is Oct. 15 – Dec. 7. As was the case last year, expect to find significant changes in the available plans and policies.

Medicare beneficiaries should read the statement of changes they should have already received from their current plans. If they’re not happy, review the alternatives available during Open Enrollment.

During Open Enrollment, beneficiaries may switch from one Medicare Advantage plan to another, from an Advantage plan to original Medicare or from original Medicare to an Advantage plan. Part D prescription drug policies also can be changed.

Medicare supplement (Medigap) policies can be changed any time during the year. The significant premium increases in 2025 are estimated to be followed by increases of 8% or more for 2026.

As happened last year, Medicare Advantage plans will have significant changes.

Beneficiaries should know that customers are less satisfied with Advantage plans, according to the J.D. Power 2025 U.S. Medicare Advantage Study. Satisfaction declined to 623 from 675 on a 1,000 point scale.

Members reported a significant decrease in their trust of plan sponsors. They also reported significantly less satisfaction with product or coverage offerings and the ease of doing business with the plans.

Enrollment in Advantage plans is expected to decrease from 34.9 million to 34 million, according to the Centers for Medicare and Medicaid Services. The percentage of beneficiaries in Advantage plans was 50% in 2025 and is expected to be 48% in 2026. In 2010, only 25% of beneficiaries were in Advantage plans.

The total number of Advantage plans will decrease to 5,600 from 5,633, according to CMS.

CMS projected that the average Advantage plan premium will decrease to $14.00 from $16.40. CMS also expects benefit options overall to remain stable.

But, those are national averages. The changes in individual plans will vary. Beneficiaries need to examine the details of individual plans before making a choice for 2026.

The major providers of Advantage plans announced they will reduce their offerings in 2026.

UnitedHealthcare, the top Advantage plan provider, said its plans will be available to 94% of Medicare beneficiaries in 2026, down from 96% in 2025.

It will not offer plans in 109 U.S. counties that have 180,000 Medicare beneficiaries.

Aetna will offer its plans in 100 fewer counties than it did this year.

Humana will offer Advantage plans in 85% of counties, down from 89% this year.

The Advantage plan sponsors say they must make adjustments for reduced funding from CMS plus overall increases in medical costs and the use of medical care by beneficiaries.

Part D prescription drug policy premiums are expected to decrease by $3.81 on average to $34.50, according to CMS. I can tell you that is not my experience. My Part D plan informed me of a substantial premium increase for 2026.

The Centers for Medicare and Medicaid Services (CMS) released data showing that for the third consecutive year the number of stand-alone Part D policies available will decline. There are 360 policies available nationwide for 2026, down from 464 in 2025.

Some insurers who have offered both stand-alone Part D policies and Medicare Advantage plans decided to concentrate on the Medicare Advantage plans because they are more profitable, according to the Kaiser Family Foundation (KFF).

The unexpected good news is that few insurers are increasing their premiums by the maximum $50 monthly allowed by CMS. In fact, most are reducing premiums by a modest amount.

An analysis by KFF found that of the 10 Part D plans offered nationwide in both 2025 and 2026, only one isn’t reducing premiums.

But what really matters are the more popular plans that dominate the market.

KFF’s analysis of these plans found that premium changes vary significantly between insurers and around the country. Some plans raised premiums in some states and not in others.

The most popular plan, Wellcare Value Script, is increasing premiums in 33 states while decreasing premiums or holding them steady in 18 states (including the District of Columbia).

The third most popular plan, SilverScript Choice, is imposing the maximum $50 monthly increase in 30 states and reducing premiums in 20 states. Its monthly premium will range around the country from $14.70 to $116.00.

Beneficiaries need to look beyond the monthly premium to the policy details. Medications an individual uses might not be covered under some policies, or the beneficiary might bear a significant higher portion of the cost of those medications under one policy than under another.

The average Medicare Part D policy doesn’t cover 44% of medications and has restrictions on nearly half of the covered medications, according to data from GoodRx Research.

Restrictions typically include prior authorization or requiring the policyholder to try a less expensive drug first, known as step therapy.

Good Rx Research also concluded that the average Part D policyholder has excess out-of-pocket costs of $840 annually because most don’t enroll in the best plan for them.

Before choosing a Part D plan, a beneficiary should make a list of all medications he or she uses regularly. The Plan Finder tool on the Medicare website can use that information to estimate the individual’s total out-of-pocket costs during the year under different plans.

A local insurance agent who specializes in Medicare coverage or a volunteer from the state’s SHIP program also can help assess the total cost of different plans.

CMS has not announced the Part B premium for 2026, but I’ve seen estimates forecasting an 11% or higher increase from 2025’s level.