If you have Medicare or a Medicare Advantage plan, it’s time to review your options. Open Enrollment for 2026 Medicare coverage runs from October 15 to December 7, 2025. During this time, you can make changes that begin January 1, 2026.
What You Can Do During the 2026 Medicare Open Enrollment Period:
- Keep your current plan (but be sure to check for any changes)
- Switch between Traditional Medicare (Parts A and B) and Medicare Advantage (Part C)
- Change Medicare Advantage plans
- Join, change, or drop a Medicare prescription drug plan (Part D) if you have Traditional Medicare
If you have Medicare Advantage, you can also make one change to your plan during the Medicare Advantage Open Enrollment Period, which runs from January 1 to March 31, 2026.
What’s New in 2026:
- Prescription drug costs are capped at $2,100 for the year, up from $2,000 in 2025. Once you reach this cap, you will not owe anything else for the rest of the year for prescriptions covered by Part D.
- The Part D deductible limit increases to $615, up from $590 in 2025. Some plans have deductibles lower than this (or none), but no plan’s deductible can be higher than $615.
- The Medicare Prescription Payment Plan lets you pay your out-of-pocket drug costs monthly instead of all at once. If you’re interested, ask your plan how to enroll.
- The Centers for Medicare and Medicaid Services (CMS) kept changes that strengthen coverage decisions, appeals, and consumer protections in Medicare Advantage and Part D. These updates were finalized for the 2026 plan year.
Some changes made in 2025 remain in place, including a cap of $35 per month or less for insulin and free adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) that are covered under Part D.
Important Reminders Before You Decide:
- Check your plan’s Annual Notice of Change. This shows upcoming changes to premiums, copays, deductibles, and prescription drug coverage.
- Make sure your medicines are still covered. The $2,100 cap applies only to drugs covered by your plan. Review your plan’s formulary and any rules (like prior authorization).
- Compare plans with the Medicare Plan Finder. Enter your ZIP code and prescriptions to see costs at local pharmacies: https://medicare.gov/plan-compare.
Not sure if Traditional Medicare or Medicare Advantage is right for you? Click here to watch our video comparing the two options.