Along with Halloween and Thanksgiving, the Medicare Annual Enrollment Period is a rite of autumn for many Medicare-eligible beneficiaries. From October 15 through December 7, Medicare enrollees can add, drop, or switch coverage for plans such as Medicare Part D and Medicare Advantage.
In any year, it’s a good idea to review your Medicare coverage for changes in costs, benefits, and medical network coverage. The recent release of price and other plan details reveals some important adjustments for 2026 to Medicare Parts A, B, and D as well as Medicare Advantage plans, and it may be useful to get help sorting out your options from sources like Medicare.gov, the State Health Insurance Assistance program, which has counselors in every state, and Fidelity Medicare Services®, which does business in every state plus the District of Columbia, although agents are not physically located in each state.
“Especially this year it might be worth taking the time to review your coverage with a Medicare expert,” says Harold Stankard, Head of Fidelity Medicare Services.
Here are some things that will change in 2026.
Changes to plan pricing
The Centers for Medicare & Medicaid Services (CMS) announced premium and deductible increases to Parts A and B for 2026. While the majority of Part A Medicare beneficiaries pay no premiums, their inpatient hospital deductibles will increase by 3.5% to $1,736 per benefit period in 2026.1 The standard Part B premium will increase to $202.90 per month in 2026 from $185 in 2025, while the annual deductible will climb $26 or 10.1% to $283.2 CMS also announced a smaller increase in the base premium for Part D to $38.99 from $36.78,3 and an increase of 4.2% in the annual deductible for Part D plans to $615 in 2026 from $590 in 2025.4
Important Part D updates
Some changes triggered by existing provisions in the Inflation Reduction Act (IRA) of 2022 will be in effect for 2026. In addition to capping the base beneficiary premium to no more than 6% above the prior year's amount for Medicare Part D,5 the Inflation Reduction Act for the first time grants Medicare the ability to negotiate drug prices under Medicare Part D directly with the pharmaceutical companies. Medicare has negotiated lower prices with pharmaceutical manufacturers for 10 high-cost, single-sourced drugs, and people will start to see negotiated prices beginning in 2026.
Good to know: In 2025 the so-called donut hole, or coverage gap, in Medicare Part D’s prescription drug coverage was eliminated, which could simplify the sharing of costs between policyholders and insurance companies and potentially lower how much you pay for your prescription drugs in a given year.
Similarly, the cap on out-of-pocket spending on drugs, which includes Part D deductible phase spending, copayments, and coinsurance, will be capped at $2,100 in 2026 (up from $2,000 in 2025), and will be indexed for inflation in future years.6 Previously there was no fixed-dollar cap on out-of-pocket spending.
Broadly speaking, the bottom line is that Medicare-eligible beneficiaries who take expensive drugs are still likely to benefit. “If you take expensive prescription drugs, costing say $6,000 to $8,000 annually, the $2,100 cap is great,” says Ben Isgur, Vice President, Fidelity Health Thought Leadership. But those who take few prescription drugs may pay more out of pocket due to premium increases.
Fidelity can help you explore Medicare Part D prescription drug plans for 2026.
A shifting landscape for Medicare Advantage
It’s important to be on the lookout for changes to Medicare Advantage plans, also known as Part C or “all-in-one” plans.
More than 50% of Medicare beneficiaries are now enrolled in Medicare Advantage (MA) plans,7 which include Parts A, B, and in some cases Part D in addition to benefits that might include dental, hearing, and vision. Under MA policies the government contracts with private insurers to provide benefits. Many plans offer prescription drug coverage that will be affected by the new $2,100 a year out-of-pocket limit, which applies to drug coverage in MA plans as well as for stand-alone Part D plans.
A key selling point is that some plans come with premiums as low as $0 (though policyholders pay a premium for the plan’s Part B coverage, as well as any higher premiums for Parts B and D if they are high earners), so a dramatic increase in premiums seems unlikely in the near term. However, companies can adjust plans to increase deductibles, boost copays, raise the out-of-pocket spending limit for in-network and out-of-network health and hospital services, or trim benefits such as for dental plans included in MA policies.
Changes to Medicare eligibility
As of July 2025, Medicare is only available to US citizens, permanent residents (green card holders), Cuban-Haitian entrants, and people residing under the Compacts of Free Association. Asylum-seekers, refugees, and people with temporary protected status, no longer qualify for Medicare.8
Review your coverage with an expert
People enrolled in Medicare plans in 2025 should have received Annual Notice of Change letters in late September or early October that outline changes in coverage for 2026. Reviewing these letters is a good first step to determine how your plans could change in 2026. Since some things could be in flux in 2026 policies, it may make sense to meet with a licensed insurance agent who specializes in Medicare during this fall’s Medicare Annual Enrollment Period to review your existing coverage and decide if you’d like to keep the same plan or switch to another.
“Every year it’s a good idea to review your financial plan and your health plan in retirement to confirm that the health plan meets your coverage preferences and health needs at the lowest cost possible,” Stankard says. In fact, there’s a large overlap between health costs and retirement financial planning: According to the 2025 Fidelity Retiree Health Care Cost Estimate, a 65-year-old person may need $172,500 in after-tax savings to meet health care expenses in retirement.9
As you prepare for a meeting with a licensed insurance agent who specializes in Medicare, here are some questions to keep in mind:
- Is my existing plan still appropriate for me?
- Does my Medicare Part D drug plan still meet my needs in 2026, or should I consider switching to another plan?
- Will I likely end up paying more or less for drugs (including for premiums) in 2026?
- What are the major changes for my Medicare Advantage plan in 2026 in terms of costs, benefits, and network coverage?
Fidelity offers Fidelity Medicare Services, with insurance agents licensed in every state who can review Medicare plans for customers living in many Zip Codes. As a complimentary service, these licensed insurance agents who specialize in Medicare can educate Medicare beneficiaries and help them enroll them in plans that might be right for their situations. There’s no need to be a Fidelity account holder to use the tools on the website or to arrange a meeting with a licensed insurance agent who specializes in Medicare who can help you map out a plan during the Medicare Annual Enrollment Period. You can also learn more about your options at Fidelity’s Medicare Annual Enrollment Period Learning Center.