Big Medicare Advantage Changes Coming in 2026 That Will Impact Millions

Medicare Advantage is the default choice for many retirees, but big changes planned for 2026 will reshape how these plans work. As part of evolving regulation and budget pressures, new policies will affect costs, provider access, and benefit structures. Knowing what's changing now helps you protect your coverage and make smarter health choices.

Here are the key changes to expect and how they may impact your retirement plan.

What is Medicare Advantage?

Medicare Advantage (also known as "Part C" or MA) is a private alternative to Original Medicare, combining Parts A, B, and often D (prescription drugs) into one plan. It typically offers additional benefits like dental, vision, and hearing.

Because MA plans are privately run but regulated, changes in government payments and rules directly shape how generous or restrictive plans can be.

How the One Big Beautiful Bill Act might impact Medicare Advantage costs

While the new legislation doesn't explicitly rewrite MA benefit rules, the "One Big Beautiful Bill" (OBBB) calls for deep funding cuts to health care programs. As a result, reductions in Medicare and Medicaid funding could lead insurers to shift more costs onto MA enrollees.

In effect, MA providers may respond by trimming extras, raising premiums, or shrinking networks to maintain sustainability.

You could be 'crosswalked' into a different Medicare Advantage plan

Centers for Medicare and Medicaid Services (CMS) will implement a "crosswalk" policy that may shift beneficiaries into different plans if their current plan gets cancelled, or if their carrier walks away from a service area that isn't profitable.

That means even if you do nothing, your plan could change for you, including in-network coverage, premiums, and deductibles.

Costs are climbing

Because of inflation and rising medical costs, many MA plans are expected to raise out-of-pocket costs, copayments, and premiums.

Additionally, the cap on Part D out-of-pocket drug spending will increase to $2,100 in 2026, up $100 from 2025. These cost pressures will likely hit those who use many medical services or rely heavily on their supplemental benefits.

Provider networks are shrinking

MA plans will tighten networks as doctors and hospitals are dropping out as a result of low reimbursement rates. In many cases, MA plans may see a shift from PPO to HMO plans, requiring referrals and raising costs for out-of-network care, which may make provider choices narrower for many enrollees.

Extra benefits are being scaled back

Several perks MA plans offered, like gym memberships, expanded dental or hearing coverage, and extra allowances, are being curtailed.

Dental benefits may shrink to only cleanings and exams, vision and hearing coverage may have tighter limits, and perks may only be offered with stricter rules. These changes may surprise those who chose MA plans for those extras.

Millions of people may be affected

It's estimated that of the 34 million people currently enrolled in MA plans, 1.5 to 2 million enrollees are expected to feel the impact. Additionally, the plan crosswalking and network adjustments may leave some beneficiaries with fewer viable options in their area.

What to do now if you're a Medicare Advantage plan enrollee

Start reviewing your current plan's 2026 Annual Notice of Change (ANOC), which should have arrived by October 1.

Compare alternative MA plans and Original Medicare, especially if your network is shrinking. Ask about premium changes, benefit reductions, and provider networks before enrolling. Consider seeing health providers now whose networks might change later.

Bottom line

Medicare Advantage in 2026 is heading into a year of significant reform, from benefit cuts, narrower networks, and cost increases to plan shifts for some enrollees. These changes aren't hypothetical; they'll impact millions who depend on MA.

To protect your coverage, review your options now, prepare for cost increases, and set yourself up for retirement in a health plan that best fits your needs.