Medicare Advantage plans 2026 are a popular alternative to traditional Medicare, allowing enrollees to receive Medicare coverage through private insurance companies. These plans typically include additional benefits like vision and dental coverage.
If you’re considering signing up for Medicare Advantage in 2026, here’s what you can expect.
Changes to Costs
Lower Premiums
The most significant change for many beneficiaries in 2026 will be lower monthly premiums. Last year, average monthly premiums for MA plans fell by 8% to $19. This downward trend is expected to continue in 2026.
Higher Out-of-Pocket Maximums
While average premiums are decreasing, out-of-pocket maximums (the most you’ll have to pay for covered services in a year) are expected to rise. In 2025, the average maximum limit was $5,171, and it is projected to increase to $5,469 in 2026.
Additional Benefits
Many MA plans offer benefits that go beyond the basic coverage provided by Medicare. These may include:
- Vision and dental care
- Fitness programs
- Transportation services
- Home health care
- Over-the-counter medications
New Special Needs Plans
New Special Needs Plans (SNPs) will cater to specific groups of individuals, such as those with chronic conditions or low income. These plans aim to provide tailored benefits, provider choices, and drug formularies that meet the unique needs of their members. For example, SNPs for individuals with diabetes may include coverage for specialized equipment and education.
Changes to Coverage
More Telehealth Options
Telehealth services have become increasingly popular during the COVID-19 pandemic, and MA plans are expected to expand these offerings in 2026. This means beneficiaries will have more flexibility in how they access healthcare, including virtual visits with doctors and specialists.
Improved Chronic Disease Management
Insurers will be required to improve how they manage chronic diseases through their MA plans. This may involve enhanced care coordination, better access to specialists, and targeted support for conditions like diabetes and heart disease.
New Requirements for Plans
Improved Transparency
Plans will be required to provide clearer information about the prices of covered services. This aims to help beneficiaries better understand their potential out-of-pocket costs and make informed choices about their care.
Better Access to Specialists
Insurers will need to ensure their MA plans provide timely access to specialist care. This could involve expanding the network of available specialists and implementing measures to reduce wait times for appointments.
Additional Resources
If you’re looking for more information about Medicare Advantage plans or health insurance options in general, consider checking out these helpful resources:
- The official Medicare website (medicare.gov) provides up-to-date information about Medicare Advantage plans and any upcoming changes in the system.
- The National Association of Insurance Commissioners (naic.org) offers resources related to health insurance and can help you understand your options.
- Your local State Health Insurance Assistance Program (SHIP) can provide personalized assistance with navigating Medicare options.
