How to Change Medicare Advantage Plans for 2026
Key Takeaways
- Starting January 1,
2026 , new prior authorization requirements will come into effect for certain services under Original Medicare in six states, aiming to streamline care and control costs.
- Medicare Part B and D will see premium increases
in 2026 , with the standard Part B premium rising by 11.6% and Part D premiums increasing by 6%, significantly affecting beneficiaries’ out-of-pocket expenses.
- Beneficiaries will benefit from a cap on the out-of-pocket cost for insulin, set at $35 for a one-month supply, and will not be required to meet a deductible for covered insulin products.
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Understanding Medicare Advantage Plan Changes for 2026
The Medicare landscape is continually shifting, and
One of the most significant changes is the decrease in average monthly medicare premiums for Medicare Advantage plans, dropping from $16.40 in 2025 to $14.00 in 2026. This reduction is part of a broader effort to make healthcare more affordable. Additionally, the average total premium for standalone Part D plans will also decrease, from $38.31 to $34.50. These changes are part of CMS’s ongoing efforts to negotiate drug costs, ensuring affordability for Medicare beneficiaries.
New features are being introduced to simplify the plan selection process. Beneficiaries can now compare plans based on whether they accept their current healthcare providers, making it easier to maintain continuity of care. Reviewing the Annual Notice of Changes (ANOC) for updates to your Medicare Advantage plan is crucial, as it outlines new requirements related to prescription drug coverage, medical costs, drug plans, and other critical details, including medicare changes.
Starting
Review Your Current Medicare Advantage Plan
Before exploring new options, reviewing your current Medicare Advantage plan is crucial. Start by checking for any changes in your plan’s provider network. Confirming that your preferred doctors and pharmacies are still in-network can prevent unexpected out-of-pocket costs.
Next, evaluate your out-of-pocket costs, including premiums and deductibles, as well as other costs, to ensure your health insurance plan meets your financial needs and prevents surprises in your healthcare expenses. Also, compare the benefits provided by your Medicare Advantage plan against your healthcare needs and budget. Identifying any gaps in coverage will help determine if a new plan might better suit your requirements. Be sure to pay attention to these factors.
It’s also critical to understand the prescription drug formulary and any changes to covered medications. Verify that your necessary prescription medications remain covered under your current prescription drug plan. Finally, consider the quality ratings of your current plan, as changes in these ratings can impact your decision to stay or switch plans. Prescription drugs are an important aspect of this consideration.
Compare 2026 Medicare Advantage Plans
With your current plan reviewed, the next step is to compare the available Medicare Advantage plans
The Centers for Medicare & Medicaid Services (CMS) is introducing new features to simplify the selection process. Beneficiaries can now filter plans based on supplemental benefits like weight management programs. An artificial intelligence-powered prescription cost estimator will also be available, allowing you to assess drug prices at local pharmacies easily. Additionally, the new features aim to enhance the experience for those utilizing Medicare and Medicaid.
For a comprehensive comparison, the Medicare.gov website and Medicare Plan Finder will provide updated resources as of October 1, 2025. These tools will help evaluate health and drug coverage options based on your specific needs, ensuring you make an informed decision.
Check Eligibility for Special Enrollment Periods
Special enrollment period allows for changes to Medicare Advantage plans outside of the standard enrollment times. You must qualify to reside in the plan’s service area to be eligible to join a Medicare health plan, ensuring the plan’s network and benefits are accessible to you.
If you’ve been living abroad, you can re-enroll in a Medicare Advantage Plan or Medicare drug plan for up to two months after returning to the U.S. These special enrollment periods provide flexibility for beneficiaries experiencing significant life changes, ensuring continuous access to healthcare coverage.
Steps to Switch Medicare Advantage Plans During Open Enrollment
The Medicare Open Enrollment period
Once you’ve selected a new plan, complete your enrollment before the December 7 deadline to avoid any gaps in coverage. The following subsections will detail the steps to enroll in a new plan and disenroll from your current plan, ensuring you are properly enrolled.
Enroll in a New Plan
To enroll in a new Medicare Advantage plan, you must have both Medicare Part A and Part B and reside in the plan’s service area. Having your Medicare number and the start dates for your Part A and/or Part B coverage ready is essential.
You can join a new plan by selecting ‘Enroll’ on the Medicare website or by contacting the plan directly via phone or their website. Ensure you have all relevant personal information ready to streamline the enrollment process. This will help you prepare to transition smoothly to your new plan.
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Disenroll from Your Current Plan
To disenroll from your current Medicare Advantage plan, you must contact your Medicare Advantage provider directly. Each plan provider has specific disenrollment processes that you must follow to ensure a smooth transition.
Following the correct procedures will help you avoid interruptions in your healthcare coverage. Ensure you have another plan lined up or return to Original Medicare to maintain your current coverage.
Considerations When Changing Plans
When switching Medicare Advantage plans, several important considerations can impact your decision. First, confirm whether your preferred doctors and pharmacies are included in the new plan’s network. Maintaining consistent access to these providers ensures continuity of care.
Maintaining continuous coverage is crucial when transitioning from one Medicare Advantage plan to another. If you disenroll, ensure you have another plan lined up or return to Original Medicare to avoid gaps in coverage. These steps will help you maintain ongoing treatment and relationships with healthcare providers.
Connect with an Expert for Personalized Help
The Medicare Advantage plan that worked last year might not be right for you
Navigating the complexities of Medicare Advantage plans can be challenging. Connecting with an expert can provide personalized guidance and extra help to make the best decision for your healthcare needs. Don’t hesitate to seek professional assistance to ensure you’re making informed choices.
Frequently Asked Questions
→ What are the key changes to Medicare Advantage plans in 2026 ?
Key changes to Medicare Advantage plans
→ How do I review my current Medicare Advantage plan?
To effectively review your current Medicare Advantage plan, assess any changes in the provider network, evaluate out-of-pocket costs, and compare the benefits to your healthcare needs, including prescription drug coverage. This thorough evaluation will ensure your plan continues to meet your requirements.
→ What should I consider when comparing new Medicare Advantage plans?
When comparing new Medicare Advantage plans, focus on the average monthly premiums, the availability of plans, and any new features that may enhance your selection. Additionally, resources such as an AI-powered prescription cost estimator can be valuable in your decision-making process.
→ What are special enrollment periods, and how do I qualify?
Special enrollment periods enable changes to Medicare Advantage plans outside regular enrollment times, allowing you to qualify if you experience significant life events, such as moving back to the U.S. after living abroad.
→ How do I switch Medicare Advantage plans during open enrollment?
To switch Medicare Advantage plans during open enrollment, evaluate your current plan, compare new options, and enroll in your new plan before the December 7 deadline. Remember to disenroll from your current plan by directly contacting your provider.
ZRN Health & Financial Services, LLC, a Texas limited liability company
Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.