Medicare Changes Coming in 2026: What Seniors Should Know
- Christian Companions
- 5 days ago
- 3 min read
As we approach 2026, there are some important changes coming to Medicare that will affect millions of older Americans. While some of these changes may increase costs, there are also new benefits and savings opportunities that can help offset these expenses. Let's walk through what's ahead so you and your loved ones can plan accordingly.
Premium Increases Are Coming, But You're Not Alone
The biggest change you'll notice is in your Medicare Part B premium, which is expected to rise from $185 to $206.50 per month – an increase of $21.50. While this 11.6% jump might feel concerning, it's important to remember that this covers your doctor visits, outpatient care, and medical equipment. The Part B deductible will also increase modestly from $257 to $288.
If you're receiving Social Security, the good news is that the 2026 cost-of-living adjustment (COLA) is projected to be around 2.6-2.8%, adding roughly $50 monthly to your benefits. After accounting for the Medicare increase, most beneficiaries will still see a net gain of about $28.50 per month.
Prescription Drug Changes: Mixed News
For prescription drug coverage (Part D), there are both increases and improvements. The annual out-of-pocket spending cap will rise slightly from $2,000 to $2,100, and the deductible increases from $590 to $615. However, here's where it gets exciting: Medicare's new drug price negotiation program launches in 2026!
This historic program has already negotiated lower prices for 10 commonly used medications, including popular diabetes drugs like Januvia and blood thinners like Eliquis. The savings are substantial – some drugs will cost 38-79% less than their previous prices.
Medicare Advantage Gets a Boost
If you're in a Medicare Advantage plan, there's good news: these plans will receive a 5.06% payment increase, which could translate to better benefits or lower costs for you. The rules are also being updated to provide clearer appeals processes and better oversight.
New Technology to Help Reduce Waste
Starting in 2026, traditional Medicare will begin using AI-assisted prior authorization in six states (New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington) to help reduce unnecessary procedures while ensuring you get the care you need. Licensed clinicians will still make all final decisions as the technology is just there to help support the process.
Planning Ahead
If you have higher income, you may see increases in your Medicare surcharges (IRMAA), and Medigap supplement premiums are expected to rise 8-12%. It's a good time to review your coverage options during the annual open enrollment period.
Insulin News
We're pleased to share some important updates about insulin affordability for Medicare beneficiaries. Since 2023, monthly insulin costs have been limited to $35 or less, based on negotiated rates and maximum fair pricing.
Starting in 2026, this protective cap will be applied on an annual basis rather than monthly.
We encourage you to review your benefit statements carefully, as insulin should not be subject to any deductible charges.
Beginning in 2026 and continuing each year thereafter, your cost-sharing for insulin will be determined by whichever amount is lowest among these three options:
A maximum of $35
25% of the maximum fair price set through Medicare's Drug Price Negotiation Program for your specific insulin product
25% of the negotiated price for your insulin product within your standalone Medicare prescription drug plan (PDP) or Medicare Advantage plan with prescription drug coverage (MA-PD)
While Medicare changes can feel overwhelming, remember that you don't have to navigate these updates alone. At Christian Companions Houston, we understand that every senior's situation is unique, and our experienced team is here to provide the personalized guidance and support you deserve as you adapt to these new healthcare developments.
If you or a loved one could benefit from professional assisted living services that work seamlessly with your Medicare coverage, we're here to help. Please call today and discover how our compassionate caregivers can ensure that 2026 brings positive opportunities for you and your family's peace of mind.
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