When Will Medicare Announce What’s Changing?
The Centers for Medicare & Medicaid Services (CMS) will release details about 2026 changes in early October. Around that time, people already enrolled in Medicare Advantage (MA) or Part D prescription drug plans should receive a notice from their insurer outlining any changes to their plan’s costs or coverage for the upcoming year.
This information is provided in a document called the Annual Notice of Change (ANOC). A more detailed explanation of your benefits can be found in the Evidence of Coverage (EOC) document. CMS also publishes an updated version of the “Medicare & You” handbook each year, which is a valuable resource for understanding your coverage.
While research from KFF shows that few people actually read these documents, it’s highly recommended that you do—they contain important details about your benefits and costs.
What Happens During the Medicare Annual Enrollment Period?
During AEP, Medicare beneficiaries have the opportunity to make changes to their coverage:
- Those with Original Medicare can enroll in a private Medicare Advantage (MA) plan.
- Those already in MA plans can switch to a different MA plan or return to Original Medicare.
- Anyone with Part D drug coverage can change to a new prescription drug plan.
Key Differences Between Original Medicare and Medicare Advantage
Here’s what sets the two options apart:
- Provider Access: Original Medicare allows you to see any provider nationwide who accepts Medicare. MA plans generally have provider networks, which can vary by region.
- Supplemental Coverage: People with Original Medicare can buy Medigap (Medicare Supplement) insurance to help cover costs not paid by Medicare.
- Premiums: Many MA plans have low—or even $0 monthly premiums.
- Out-of-Pocket Protection: MA plans include an annual out-of-pocket maximum, which limits how much you’ll spend each year on covered services. Original Medicare does not.
- Extra Benefits: MA plans often include routine dental, vision, and hearing coverage, as well as other perks such as gym memberships—benefits not offered by Original Medicare.
How Medigap (Medicare Supplement) Plans Work
If you already have a Medigap plan, you don’t need to take action during AEP. Medigap benefits are standardized and guaranteed renewable, meaning you keep your plan as long as you pay your premiums.
You can apply for a Medigap plan at any time during the year if you have Original Medicare. However, outside your initial enrollment window, insurers can deny your application or charge higher rates based on health status. Always confirm eligibility before dropping or changing coverage.
What Health Care Changes Might Affect 2026 Plans?
Several developments could influence Medicare plans for 2026:
- Increased Oversight: CMS has introduced stricter cost-control and compliance measures for both Medicare and private MA plans.
- New Federal Budget Rules: Provisions from the recently passed federal budget law are being implemented. Check your ANOC and EOC for specific plan impacts.
- Prescription Drug Price Negotiation: CMS will expand the list of high-cost drugs subject to Medicare price negotiations under the Inflation Reduction Act (IRA).
- Rising Part D Out-of-Pocket Cap: The annual maximum for Part D drug expenses will increase from $2,000 to $2,100, adjusted for inflation.
How to Prepare for Medicare Annual Enrollment
Start by logging into your MyMedicare.gov account to review your current plan details. Make a list of your prescriptions—Medicare’s tools will use this to estimate your Part D costs under different plans in your area.
Then, use Medicare’s plan comparison tools to explore MA, Part D, and Medigap options. You’ll find information on premiums, copays, deductibles, and estimated total costs based on typical usage.
Before making any changes, contact your preferred insurers directly to confirm plan details and ensure you fully understand your coverage.
Final Thoughts
Choosing the right Medicare plan is one of the most important decisions beneficiaries make each year. Take time to review your options carefully. Use Medicare’s online tools, read your plan documents, and seek advice from trusted friends, family, or licensed professionals. Doing your homework now can help you find a plan that best fits your health needs and budget for 2026.
