Medicare Changes for 2026-AARP
Changes Coming To Medicare In 2026
With Medicare open enrollment here and 2026 approaching, there are some changes to Medicare for next year, according to an AARP article entitled “7 Changes Coming to Medicare in 2026,” dated October 10, 2025. The effect of these changes will vary depending on individual situations, and it’s always important to understand the fine print, but highlights are summarized below.
- Lower costs on certain drugs
Ten high-cost prescription drugs will be available at lower prices in 2026 for Medicare beneficiaries. These include the insulins Novolog and Fiasp. The reduced costs are the result of a 2022 law that required the federal government to negotiate for lower prices on ten popular brand-name, high-priced drugs.
- An additional opportunity to switch plans for some enrollees
For 2026, the federal government’s “Medicare Plan Finder” will begin including information about providers that are in-network in Medicare Advantage plans. The goal is to have complete information about provider networks on the plan finder website, but the information is not yet complete. If Medicare Advantage enrollees who used the plan finder during their first three months on a new plan discover that the plan finder had inaccurate information and their doctors are not in-network, they will be eligible to switch to a plan that has their providers, or to original Medicare (Parts A and B), during a special enrollment period.
- Increases in deductibles and spending caps for Medicare Part D
The $2,000 limit on out-of-pocket expenses for prescription drug plans will go up to $2,100 in 2026. Also increasing is the maximum Part D deductible, which will go up to $615 (from $590 in 2025). Some Part D plans will have lower deductibles or none at all.
- No reenrollment in prescription drug plans needed
Beginning in 2025, the Medicare Prescription Payment Plan offered the option to pay out-of-pocket prescription drug costs in monthly installments rather than all at once at a pharmacy. To make enrollment easier in 2026, those who participated in 2025 will be reenrolled automatically unless they opt out or change plans. Those who do change plans and want to continue paying monthly should contact their new drug plan.
- Pilot program for prior authorization under original Medicare
In a six-year experiment that begins January 1, 2026, millions of original Medicare beneficiaries in six states could be required to get prior authorization before certain medical services, procedures or devices are covered. The states are Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington. If successful, the pilot project could lead to wider use of prior authorization in original Medicare, possibly using AI. Technology companies that participate in the project will be paid based on savings from denied medical claims.
- Termination of supplemental benefits pilot program
More than seven million people enrolled in Medicare Advantage plans may no longer be eligible for an array of extra benefits due to the termination of a pilot program targeted at low-income Medicare beneficiaries. The program, which is being terminated because of cost, provided benefits such as lower prescription drug costs, food assistance, transportation to medical appointments and support to help manage chronic health conditions.
- Medicare Advantage plan limits on nonmedical benefits
A 2018 law expanded the types of supplemental benefits that Medicare Advantage plans could offer to chronically ill enrollees. These benefits do not have to relate to health, but must have a reasonable expectation of improving or maintaining the health or function of someone with a persistent medical condition. Beginning in 2026, certain benefits will be excluded from coverage because they do not meet this standard.
Here’s the link to the article: https://www.aarp.org/medicare/whats-new-in-medicare-2026/.
Last updated 10/24/2025.