Medicare Open Enrollment 2026: Special Rules and Benefit Changes You Shouldn’t Miss

Medicare Open Enrollment is back and for 2026, millions of Americans will face higher costs, fewer plan options, and new rules that could impact their coverage.

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Prescription Drug Costs Now Capped

• The out-of-pocket spending cap for Medicare Part D will increase from $2,000 in 2025 to $2,100 in 2026 under the Inflation Reduction Act.

• After beneficiaries reach this $2,100 limit, they will not pay any more for covered medications for the rest of the year.

• This change is expected to help seniors better manage and predict drug costs, especially those with chronic conditions or multiple prescriptions.
   

Fewer Plan Options in Some Areas

• Insurers are reducing the number of Medicare Advantage (Part C) and stand-alone Part D plans.

• Some regions will see fewer available plans, making it critical to review and compare options early in the enrollment window.

• Experts recommend checking your current plan and exploring alternatives before the December 7 deadline.

Premiums and Deductibles Are Increasing

• Part B premium will rise from $185 to about $206.50/month in 2026 — an 11.6% increase.

• Part B deductible is also going up by around 12%.

• Part D deductible will increase to $615 from $590.

• These changes mean even those who keep their current plans will likely pay more each month.

What Beneficiaries Should Do

• Review your Annual Notice of Change (ANOC), which outlines how your current plan will change next year.

• Compare plans to find the best coverage and pricing for your needs.

• Take advantage of new out-of-pocket caps to lower prescription costs.

• Consider switching plans if your premiums or drug coverage will rise significantly.

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