Making Sense of Medicare 2026: A Practical Guide for Houston Area Seniors

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Every year, Medicare beneficiaries across Houston face the same challenge: understanding what's changing, what it means for their wallets, and how to make the most of their benefits.

If you've found yourself confused by the letters arriving in your mailbox or overwhelmed by the numbers, you're not alone. Medicare's annual adjustments can feel like trying to solve a puzzle where the pieces keep changing shape.

The 2026 changes are particularly significant, bringing both cost increases that will stretch budgets and new savings opportunities that could substantially reduce medication expenses.

Let's cut through the complexity and focus on what Houston seniors need to know right now.

Understanding the Cost Increases

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Part B Premium and Deductible Changes

If you're enrolled in Medicare Part B, which covers doctor visits, outpatient care, and medical equipment, you'll see an increase in your monthly premium.

The standard Part B premium for 2026 is $202.90 per month. While this represents an increase from previous years, it's important to note that higher-income beneficiaries may pay more based on modified adjusted gross income from two years prior.

The Part B deductible has also risen to $283 annually. This is the amount you'll need to pay out-of-pocket before Medicare starts covering its share of services. For context, once you've met this deductible, Medicare typically covers 80% of approved costs, leaving you responsible for the remaining 20%.

Part D Prescription Drug Coverage

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For those with Medicare Part D prescription drug coverage, the out-of-pocket maximum has increased to $2,100 for 2026—a $100 increase from 2025. This cap represents the most you'll pay for covered medications during the year before catastrophic coverage kicks in.

While an increase is never welcome news, this cap provides crucial protection against unlimited drug costs, especially for those managing multiple chronic conditions. 

The Silver Lining: Medication Savings Opportunities

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While premium increases understandably grab headlines, 2026 brings significant opportunities to save on prescription medications—savings that could far outweigh the premium increases for many Houston seniors.

Medicare Drug Price Negotiation

For the first time in Medicare's history, the program has negotiated lower prices for specific high-cost medications. Ten medications are now subject to Medicare Drug Price Negotiation, resulting in substantially lower prices. These medications include treatments for conditions like diabetes, heart disease, blood clots, and autoimmune disorders—conditions that affect millions of older Americans.

If you currently take any of these medications, you could see significant savings at the pharmacy counter. The negotiated prices represent reductions of up to 79% for some drugs, translating to thousands of dollars in annual savings for those who rely on these treatments.

Medicare Prescription Payment Plan

One of the most helpful yet underutilized features is the Medicare Prescription Payment Plan, which allows you to spread out your prescription drug costs over monthly installments rather than paying large sums upfront. This can be particularly valuable during the early months of the year when you're working toward meeting your deductible.

Here's welcome news: if you participated in the Prescription Payment Plan in 2025, you'll be automatically renewed for 2026. You don't need to do anything—the enrollment continues seamlessly. If you didn't participate last year but think this option could help manage your cash flow, contact your Part D plan to enroll.

What Houston Seniors Should Do Now

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Review Your Current Medications

Take inventory of all prescription medications you currently take. Check whether any are among the ten drugs with newly negotiated prices. Your pharmacist can help identify which medications are affected and estimate your new costs. Many Houston-area pharmacies, including those at major chains and independent pharmacies, have staff specifically trained to assist with Medicare questions.

Compare Part D Plans

Even if you're generally satisfied with your current Part D plan, it's worth comparing during the annual enrollment period. Plans change their formularies (lists of covered drugs) and cost structures every year. A plan that worked well for you last year might not be the best value in 2026, especially with the new negotiated drug prices.

Consider Extra Help Programs

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If you have limited income and resources, you may qualify for Extra Help (also called the Low-Income Subsidy), which helps pay Part D premiums, deductibles, and copayments.

In Texas, individuals with annual income below approximately $23,000 or couples below $31,000 may qualify. The Harris County Area Agency on Aging at

713-794-9001 can help you determine eligibility and apply.

Understand Your True Costs

Don't focus solely on premium amounts when evaluating plans. Your total cost includes premiums, deductibles, copayments, and coinsurance. A plan with a slightly higher premium might actually cost you less overall if it offers better coverage for your specific medications or includes your preferred Houston-area pharmacies in its network.

Get Local Help

Medicare decisions are complex, and you don't have to figure this out alone. The Harris County Area Agency on Aging offers free counseling to help seniors understand Medicare options and make informed decisions. AARP also provides resources specifically addressing Medicare changes, including calculators to help estimate your costs.

Looking Ahead

Yes, 2026 brings cost increases that will affect your budget. But it also represents a turning point in Medicare's ability to negotiate fair drug prices—something advocates have sought for decades. For many Houston seniors, particularly those taking expensive medications for chronic conditions, the drug savings could exceed the premium increases.

The key is staying informed, reviewing your options carefully, and taking advantage of the resources available to help you navigate these changes. You've earned these benefits through years of work and contributions. Make sure you're getting the maximum value from them.

If you or a loved one need support navigating these Medicare changes or assistance with daily medication management, companionship, or compassionate elder care, Christian Companions - Houston is here to help. Our dedicated caregivers understand that managing healthcare in your senior years involves more than just understanding insurance—it's about having someone by your side who genuinely cares.

Resources:

1. https://www.goodrx.com/insurance/medicare/medicare-changes-2026

2. https://www.medicareresources.org/faqs/what-kind-of-medicare-benefit-changes-can-i-expect-this-year/

3. https://www.aarp.org/medicare/whats-new-in-medicare-2026/

4. https://www.aarp.org/medicare/first-medicare-negotiated-drug-prices-debut/