Medicare beneficiaries are facing one of the most critical open enrollment periods in the 60-year history of the program as sweeping cost increases and plan changes start to set in for 2026. With Medicare Part B premiums projected to increase by $21.50 to $206.50 a month and Part D prescription drug coverage plan premiums potentially increasing by as much as $50 a month, being aware of your options during the October 15 to December 7 enrollment period has never been more important. For more information on the different parts of Medicare, read this article, Why does Medicare have different parts? What are Parts A, B, C, D — and what is Medigap?
Comprehending the 2026 cost hikes
The 2026 Medicare landscape will witness huge budget changes, affecting millions of recipients. Part B premiums, for instance, will rise from $185 in 2025 to $206 in 2026, this is a 12% increase. Part B deductibles will rise from $257 to $288, while the Part D deductible, a maximum out-of-pocket expenditure for prescription drugs, will rise from $590 to $615, and a maximum out-of-pocket expenditure for prescription drugs, known as catastrophic limits, will rise from $2,000 to $2,100.
But some enrollees will have some good news. Medicare Advantage premiums with prescription coverage should drop on average from $16 in 2025 to $14 in 2026; similarly, the monthly standalone Part D plan should fall to a minimum of $34 compared to $38 of this past year. But the insurance providers can now hike the figures the amount it can reach for Part D to a high of $50, three times more than the prior $35 caps instituted.
Read your annual notice of change closely
All Medicare Advantage and Part D members get an Annual Notice of Change (ANOC) on or before September 30, which summarizes all changes to coverage, costs, and benefits for the next year. This notice is your contract and should be read carefully and not just discarded as promotional material. The ANOC summarizes changes in monthly premiums, deductibles, copayments, coinsurance, prescription drug lists, provider networks, and supplemental benefits like dental, vision, and hearing benefits.
Specifically, pay close attention to whether your current medications are still covered and if they have switched to a higher or lower cost tier, which might drastically impact your out-of-pocket costs. Of equal importance is checking that your desired physicians, hospitals, and pharmacies continue to be within your plan network. Insurers are ending plans, lowering hospital affiliations, and diminishing physician networks in 2026.
Compare plans using Medicare’s plan finder tool
The Medicare Plan Finder at Medicare.gov is an essential resource to employ when making comparisons of coverage options during open enrollment. The web tool allows you to enter your medications and preferred pharmacies so you can see estimated yearly costs under different plans. You can rank results by plan benefits like dental and vision, drug coverage, and star ratings, which indicate plan quality and performance from one through five stars.
The website allows comparison of up to three plans at once, including premiums, deductibles, and cost-sharing details. Four- and five-star plans typically reflect better quality service and customer experience. For 2026, the average Medicare beneficiary has access to 32 Medicare Advantage prescription drug plans, slightly fewer than the 34 in 2025 but more than in earlier years.
Think about changing your plan types
Open enrollment permits you to switch from Original Medicare to Medicare Advantage, switch your Medicare Advantage plan, or modify your Part D prescription drug coverage. If currently you have Original Medicare and a stand-alone Part D plan and Medigap policy, switching to a Medicare Advantage plan will save you money, especially with rising Medigap premiums. The majority of Medicare Advantage plans have no premiums, provide coordinated prescription drug coverage, and include supplemental benefits such as dental, vision, and hearing care that are not included in Original Medicare.
But carefully examine provider networks, services that are covered, and cost-sharing requirements prior to changing. Medicare Advantage plans often require you to see in-network providers and can impose prior authorization and step therapy for certain drugs. If you see specialists regularly or need certain health care, ensure that your physicians and medications are covered under any new plan.
Review your prescription drug coverage
Prescription medication coverage warrants extra attention during open enrollment because formularies change annually. A covered medication this year could no longer be covered, or it could move to a higher tier with greater copays. Enter all of your current drugs into the Plan Finder tool and view estimated yearly costs under different Part D plans.
For 2026, your out-of-pocket expense limit for Part D drugs remains $2,100, so your plan covers 100% of covered medication expenses once you hit this amount. The Medicare Prescription Payment Plan also allows beneficiaries to pay out-of-pocket drug charges during the course of the year, rather than paying significant amounts at the time you pick it up at the pharmacy. Once you enroll in this payment plan in 2026, you’ll be automatically enrolled in 2027 unless you opt out.
Medicare Savings Programs (MSPs) pay Part B premiums, deductibles, and coinsurance for eligible people. MSPs provide a big help financially, particularly because premiums increase for 2026. You can apply in your state office or the Social Security Administration website at socialsecurity.gov/extrahelp.
Consider your use of healthcare and your needs
Take time to review how you used your coverage in the past year and determine if your current plan still meets your needs. Consider if your health has shifted, requiring new specialists or services. Did you reach your out-of-pocket limit? Were certain benefits not used? Did your drugs change? Having your plan align with your life by not auto-renewing rather than overpaying for coverage you will not use or being underinsured in important areas.
If your doctor’s bills are always low, a plan with higher cost-sharing and lower premiums might be the least expensive option. Conversely, if you anticipate increased healthcare needs, a plan with higher premiums and lower cost-sharing for doctor visits and hospitalization might be better.
Don’t wait to make changes
Open enrollment ends on December 7, 2025, and changes received during this time take effect on January 1, 2026. Missing this opportunity restricts your options for adjusting coverage until the following enrollment period. It is actually true that almost seven out of ten Medicare beneficiaries fail to compare plan choices at open enrollment, which is a costly error. Medicare Advantage and Part D plans usually differ significantly from year to year in premiums, cost-sharing, drug coverage, and physician networks.
For assistance in navigating your options, the State Health Insurance Assistance Program (SHIP) offers free one-on-one counseling throughout the country. Medicare Rights Center also has a consumer helpline at 800-333-4114, and you can call Medicare directly at 800-633-4227 to view plans available where you live and enroll. With premiums increasing and benefits transforming greatly for 2026, timely review of your Medicare benefits during this open enrollment will save you hundreds or thousands of dollars next year.
