What the 2026 Medicare Annual Enrollment Period Means for Your Coverage

The Medicare Annual Enrollment Period, known as AEP, is a yearly window when people with Medicare can review their current coverage and make changes for the following year. In 2026, AEP runs from October 15, 2025, through December 7, 2025. During this time, Medicare beneficiaries can switch between Original Medicare and Medicare Advantage plans, change their prescription drug coverage, or join a Medigap supplemental policy—depending on their current coverage type.

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Understanding how AEP works matters because choices made during this period affect your healthcare costs and coverage for all of 2026. If you don't make any changes during AEP, your current plan continues into the new year with potential changes to premiums, copayments, and deductibles. According to Centers for Medicare & Medicaid Services data, approximately 59 million people were enrolled in Medicare as of 2024, and millions of them review their options each year during AEP.

The 2026 AEP guide provides information about what typically changes from year to year in Medicare plans. Plan networks may shift—meaning doctors and hospitals you currently use might no longer be part of your plan or might move to a different tier with different costs. Formularies, which are the lists of prescription medications covered by plans, frequently change. Drug tier placements can shift, meaning a medication that was in a lower cost tier in 2025 might move to a higher tier in 2026, potentially increasing your out-of-pocket costs.

Premiums for most Medicare plans tend to increase annually, though some plans may see decreases. The Social Security Administration announced that the Medicare Part B premium for 2025 would be $174.70 per month for most beneficiaries, representing changes from previous years. Part D prescription drug plan premiums vary widely based on the specific plan and which medications you take, with some plans charging $10 monthly while others charge $150 or more.

Practical Takeaway: Set a calendar reminder for mid-October 2025 to begin reviewing information about your current Medicare coverage and what changes might occur for 2026. Gather your current insurance cards, a list of your regular doctors and pharmacies, and your current prescription medications before diving into plan comparisons.

Key Changes Expected in 2026 Medicare Plans

Each year, Medicare plans undergo significant modifications in their structure, networks, and cost-sharing details. The 2026 guide explains common types of changes that historically occur and what to watch for when reviewing your options. These changes don't happen randomly—they reflect adjustments by insurance companies, policy shifts at the federal level, and the actual claims data from previous years.

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Plan networks represent one of the most important changes to monitor. A Medicare Advantage plan might narrow its network in certain geographic areas, meaning fewer doctors or hospitals participate. Conversely, some plans expand their networks. If your primary care doctor, specialist, or preferred hospital is no longer in your plan's network in 2026, you would need to either switch to a plan that includes them or accept seeing different providers. The 2026 guide typically includes information about how to check network changes using Medicare's Plan Finder tool.

Formulary changes directly impact people taking prescription medications regularly. Insurance companies adjust which drugs they cover and at what cost tier. A medication you take might move from Tier 1 (lowest cost) to Tier 3 or 4 (higher costs). Some drugs may be removed from coverage entirely, though Medicare requires plans to maintain coverage for most medications used to treat chronic conditions. In 2023, the Medicare Payment Advisory Commission noted that beneficiaries taking multiple medications often face formulary changes that increase their annual drug costs by $100 to $500 or more.

Cost-sharing structures also change regularly. Copayments for specialist visits, urgent care, or emergency room visits might increase. Deductibles—the amount you pay out-of-pocket before your plan begins sharing costs—frequently rise. Some Medicare Advantage plans introduce or modify their out-of-pocket maximums, which set an annual limit on what you pay for covered services. In 2025, the out-of-pocket maximum for Medicare Advantage plans could not exceed $7,735 for in-network services, but this figure changes yearly.

Star Ratings, which are quality measures assigned by the Centers for Medicare & Medicaid Services, sometimes improve or decline for specific plans based on member satisfaction, customer service, and clinical quality measures. A plan that earned high ratings in 2025 might see ratings adjust in 2026 based on new performance data. The 2026 guide can help you understand how Star Ratings work and why they matter when comparing plans.

Practical Takeaway: Create a comparison spreadsheet listing your current plan's premiums, deductibles, copayments, and your regular medications and their costs. Then use this same format to document the same details for any new plans you're considering for 2026, making side-by-side comparisons much simpler.

How to Use Medicare Plan Finder to Compare 2026 Options

The official Medicare Plan Finder tool, available at Medicare.gov, is the primary resource for comparing all Medicare plans in your area for a specific year. The 2026 AEP guide typically includes step-by-step information about navigating this tool effectively. While Plan Finder can appear complex at first, breaking down the process into smaller steps makes it manageable for most users.

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To use Plan Finder for 2026 plans, you'll enter your ZIP code to see which plans are offered in your area. Medicare is divided into regions, and each region has different plan offerings—a plan available in one state or county may not be offered in another. You'll also enter your current medications using the drug search feature, and Plan Finder will show you which plans cover each drug and at what cost tier. This feature proves invaluable if you take multiple medications, because costs can vary dramatically between plans based on their formularies.

The tool displays estimated annual costs for each plan, typically calculated based on the medications and providers you've entered. These estimates help you understand the total financial picture—some plans have low premiums but high copayments, while others have the opposite structure. According to Centers for Medicare & Medicaid Services data, comparing plans can reveal annual cost differences of $1,000 to $3,000 or more for beneficiaries with significant healthcare needs.

Plan Finder also includes quality information through the Star Ratings system. Plans earning 4 or 5 stars have historically performed better on measures like member satisfaction, getting an appointment, and medication adherence compared to plans with lower star ratings. While Star Ratings don't determine which plan is best for you personally, they provide context about plan performance that can inform your decision. The guide explains how to interpret these ratings and what they actually measure.

The tool's provider search feature shows whether your current doctors and hospitals participate in each plan. You can search for individual providers by name or search by specialty in your area. This is critical because the wrong plan choice could mean losing access to a trusted doctor or specialist. If you see a cardiologist, orthopedic surgeon, or other specialist regularly, confirming their participation in any plan you're considering should be a top priority in your 2026 review.

Practical Takeaway: Set aside an hour to walk through Medicare Plan Finder using the specific information from the 2026 guide as reference material. Have your medications listed and your doctors' names readily available. Write down the names and Star Ratings of the three to five plans that appear most promising so you can research them further or discuss them with family.

Original Medicare Versus Medicare Advantage: Understanding Your 2026 Options

People with Medicare typically choose between two main coverage structures: Original Medicare or Medicare Advantage. Understanding the fundamental differences between these options is essential for making an informed decision during 2026 AEP. The choice isn't simply about cost—it involves understanding how each system works and which aligns better with your healthcare needs and preferences.

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Original Medicare includes Part A, which covers hospital stays, skilled nursing facility care, hospice, and home health services, and Part B, which covers doctor visits, outpatient services, and certain preventive care. Original Medicare is run by the federal government, and any doctor or hospital that accepts Medicare accepts your coverage—meaning you can see any provider without referrals. However, Original Medicare typically requires you to pay a deductible, coinsurance (a percentage of costs), and doesn't have an out