- Plan Discontinuation: A large number of Medicare Advantage plans are expected to be canceled or discontinued for 2026, which could affect over a million people.
- Increased Costs: Part B premiums and Part D deductibles are projected to rise.
- Out-of-Pocket Limit: The maximum out-of-pocket limit for in-network services under Part A and Part B will decrease slightly to $9,250 in 2026, down from $9,350 in 2025.
- PPO Plan Reduction: UnitedHealth Group, a major insurer, plans to eliminate plans serving over 600,000 members, with a focus on reducing PPO offerings due to their higher costs for insurers.
- SSBCI Benefits Restrictions: Plans will be restricted from offering non-healthy food, alcohol, tobacco, and life insurance as part of Special Supplemental Benefits for the Chronically Ill (SSBCI).
- Shift in Plan Focus: There may be a shift away from supplemental benefits like grocery cards and cash back, toward more focus on core healthcare coverage.
- Increased Federal Payments: The Centers for Medicare & Medicaid Services (CMS) projected an increase of 5.06% in payments to Medicare Advantage plans for 2026.
What to Do If You Are Affected
Be Proactive: If you receive a notice that your plan is being discontinued, you will not be automatically enrolled in a new plan.
Find a New Plan: You will need to find a new Medicare Advantage plan or return to Original Medicare during the appropriate enrollment period.
Consider Original Medicare: If you lose your plan, you could default to Original Medicare, which has no out-of-pocket cost limit and does not include prescription drug coverage.
Contact Us today or schedule an appointment to review you medicare benefits.