If you’re on Medicare, this open enrollment period is more important than usual. For coverage that starts January 1, 2026, you can review and change your plan from October 15 to December 7, 2025. After that window closes, most people are locked in until next year. Medical News Today+1

Health policy experts warn that 2026 will bring higher out-of-pocket costs for many people, fewer plan choices in some areas, and shifting rules around drug coverage and telehealth. The good news is that most of the impact depends on which plan you choose, which means careful comparison shopping can still save you money. Medical News Today+1

Below are the three biggest cost changes to know about for 2026, followed by practical steps you can take during open enrollment.

1. Premiums are shifting: Part B up, some Advantage and drug plans down

Part B will cost more

The Centers for Medicare & Medicaid Services (CMS) has confirmed that the standard Part B premium will rise to $202.90 per month in 2026, up from $185.00 in 2025. The annual Part B deductible will also increase, from $257 to $283. CMS+1

For most retirees, Part B is taken directly out of their Social Security benefits, so this increase will eat into part of the 2026 cost-of-living adjustment.

Medicare Advantage and Part D premiums: averages slightly lower

While Part B is going up, average premiums for private plans are moving in the opposite direction:

  • Medicare Advantage (MA) plans with drug coverage are expected to fall from an average of about $16 per month in 2025 to about $14 in 2026. Medical News Today+1

  • Standalone Part D prescription drug plans should see average premiums dip from roughly $38 to $34 per month. Medical News Today+1

However, these are averages. Insurers will have the flexibility to raise some Part D premiums to as high as $50 per month, so depending on your plan, your personal premium could go up or down. Medical News Today+1

Fewer plans and potential service cutbacks

CMS estimates there will be around 5,600 Medicare Advantage plans nationwide in 2026, similar to 2025 but down from earlier years. Some insurers, including major national players, are shrinking their service areas or dropping certain plans entirely. Medical News Today+1

On top of this, the expiration of some temporary telehealth expansions and uncertainty around federal funding mean that:

  • Telehealth options may be reduced for some beneficiaries

  • A prolonged government shutdown could slow claims processing and payments to providers, creating delays in care and reimbursement Medical News Today+1

What this means for you:
Don’t assume your current plan will look the same next year. Check your Annual Notice of Change (ANOC) and compare at least two or three alternatives in your area.

2. Deductibles and out-of-pocket limits are changing

Even if your premium looks stable, what you pay when you actually use care may change in 2026.

Medicare Advantage out-of-pocket maximum

For people in Medicare Advantage:

  • The in-network annual out-of-pocket maximum (MOOP) will drop slightly from $9,350 in 2025 to $9,250 in 2026. Medical News Today+1

That’s a modest improvement, but it’s still a very high ceiling for someone on a fixed income.

Part D drug spending cap and deductibles

The Inflation Reduction Act continues to reshape Part D:

  • The annual out-of-pocket cap for Part D drugs will increase from $2,000 in 2025 to $2,100 in 2026. Once you hit that amount, you won’t pay additional copays or coinsurance for covered Part D medications for the rest of the year. Medical News Today+2Medicare+2

  • The maximum Part D deductible is rising from $590 to $615. Individual plans can choose a lower deductible, but none can go above this limit. Medical News Today+1

Insulin will remain capped at $35 per month for many enrollees, and most vaccines recommended for adults should continue to be fully covered under Part D. Medical News Today+1

Higher medical deductibles

As noted above, the Part B deductible is increasing to $283, and Part A hospital deductibles and coinsurance will also tick upward. CMS+1

What this means for you:
Focus not just on premiums but on:

  • Deductibles

  • Copays and coinsurance for your typical services

  • The plan’s out-of-pocket maximum

Someone with frequent doctor visits or expensive medications might be better off with a slightly higher premium but lower cost sharing.

3. Prescription drug coverage is being reshaped

Changes to Medicare’s drug benefit may help some people but hurt others, depending on which medications they use.

Fewer standalone drug plans

The number of standalone Part D plans is expected to drop from 464 nationwide in 2025 to about 360 in 2026. Medical News Today+1

Fewer options can simplify choice, but it also means:

  • Your current plan could disappear or merge

  • The list of covered drugs (formulary) may change

  • Medications might move to higher cost tiers

Price negotiations and payment flexibility

Medicare will continue negotiating prices on some high-cost drugs, including widely used blood thinners and diabetes medications. Analysts estimate potential price reductions of roughly 38% to 79% off list prices for certain targeted drugs, though how much of that savings reaches individual patients will vary by plan. Medical News Today+1

At the same time, the Medicare Prescription Payment Plan lets people spread their Part D drug costs evenly across the year instead of paying big amounts all at once, which can help with budgeting. Medicare+1

What this means for you:
If you take brand-name or specialty drugs, it is critical to:

  • Check whether your medications are still on your plan’s formulary

  • See if they’ve moved to a different tier with higher copays

  • Compare at least one or two other plans using the same drug list

How the possible government shutdown and telehealth changes fit in

Some of the strain in 2026 may come not from formal benefit changes but from the broader policy environment:

  • A prolonged federal government shutdown could slow Medicare claims processing and provider payments, causing delays or billing confusion for beneficiaries. Medical News Today+1

  • The expiration of some pandemic-era telehealth flexibilities means certain virtual services may no longer be covered or may have tighter rules, which hits rural residents, people with disabilities, and caregivers especially hard. Medical News Today+1

If you’ve been relying heavily on telehealth, check whether your preferred providers still offer covered virtual visits under your plan for 2026.

What you should do during open enrollment

Here is a simple checklist to use before December 7, 2025:

  1. Review your Annual Notice of Change (ANOC)

    • Look for changes in premiums, deductibles, copays, drug formularies, and provider networks.

  2. Make a complete list of your doctors and medications

    • Include dosage, frequency, and which pharmacies you use most.

  3. Use the Medicare Plan Finder or a trusted marketplace

  4. Check provider networks and prior authorization rules

    • Especially important if you’re in a Medicare Advantage plan.

  5. Get free help if you feel overwhelmed

    • State Health Insurance Assistance Programs (SHIPs), certified insurance agents, or reputable online marketplaces can walk you through options. medicareresources.org+1

  6. Re-evaluate every year

    • Experts estimate that around 70% of beneficiaries don’t compare plans annually, even though switching can save hundreds or even thousands of dollars. Medical News Today+1

Bottom line

In 2026, Medicare isn’t standing still:

  • Part B costs more

  • Out-of-pocket limits and deductibles are shifting

  • Drug coverage is being reworked, with fewer standalone plans and new rules on pricing

For many people, these changes will mean higher costs unless they take the time to shop around. The choices you make before December 7, 2025 can determine not just what you pay next year, but also which doctors you can see and how easily you can access needed medications.

This article is general information, not personal financial or medical advice. Before making changes to your coverage, consider speaking with a licensed insurance professional, your pharmacist, or another qualified advisor who understands your specific situation.