News & Trending Insurance News

10 Medicare Changes for 2026 That Will Impact All Retirees

Medicare costs are rising again in 2026. Here's a closer look at what's changing.

By Stacy Garrels

Edited by Sara Albertelli

Updated Dec. 1, 2025

Big changes are coming for the roughly 69 million Americans receiving Medicare coverage, in particular, the 91% of plan participants enrolled in Part A and Part B.

Policy watchers anticipate a series of cost and coverage changes in 2026, with some of the biggest shifts impacting deductible amounts, prescription drug costs, and eligibility requirements.

Staying informed is one of the best ways to avoid wasting money in retirement, so here's a breakdown of what we know so far about the most far-reaching changes ahead.

Get instant access to hundreds of discounts

Over 50? Join AARP today— because if you’re not a member you could be missing out on huge perks like discounts on travel, dining, and even prescriptions.

Get 25% off membership — just $15 for your first year with auto-renewal — and a free gift if you join today.

Become an AARP member now

Prepare for a significant Medicare Part B premium increase

The standard Medicare Part B premium is expected to rise from $185 per month in 2025 to $206.50 in 2026, an 11.6% jump, or more than double last year's increase.

The annual Part B deductible is projected to grow as well, from $257 to $288, a 12% bump.

Who really has the cheapest auto insurance in your area? Check your zip code here.

Plan for higher prescription drug costs before coverage kicks in

Prescription drug costs under Medicare Part D will shift in 2026. The federal cap on the standard Part D deductible will rise to $615, up from $590 in 2025.

While some plans may still offer lower deductibles or $0 premiums, Medicare.gov warns that drug costs and coverage details vary by plan, so enrollees may see different out-of-pocket amounts depending on the coverage they choose.

Expect a higher catastrophic threshold under Part D

Medicare Part D's catastrophic spending limit (the point where your out-of-pocket drug costs stop) will increase from $2,000 to $2,100 in 2026.

Once you hit that threshold, Medicare covers 100% of your covered prescription costs. Even with the small increase, the Inflation Reduction Act maintains strong protections for seniors with chronic or high-cost medication needs.

Get a protection plan on all your appliances

Did you know if your air conditioner stops working, your homeowner’s insurance won’t cover it? Same with plumbing, electrical issues, appliances, and more.

Whether or not you’re a new homeowner, a home warranty from Choice Home Warranty could pick up the slack where insurance falls short and protect you against surprise expenses. If a covered system in your home breaks, you can call their hotline 24/7 to get it repaired.

For a limited time, you can get your first month free with a Single Payment home warranty plan.

Get a free quote

Don't expect the hold-harmless rule to shield you

Medicare's "hold-harmless" provision protects many beneficiaries from seeing their Social Security checks drop when Medicare Part B premiums rise.

Under this rule, a beneficiary's Social Security payment can't go down if the dollar amount of their Part B premium increase is larger than the dollar amount of their annual Social Security cost-of-living adjustment (COLA).

Because the rule ties protection to the size of a person's COLA, it mainly helps beneficiaries with smaller Social Security payments. Those receiving larger monthly benefits typically experience full Part B premium increases.

Your IRMAA could go up

Higher-income seniors may also face paying for IRMAA, or the Income-Related Monthly Adjustment Amount.

The IRMAA is a surcharge that higher-income participants may pay if their modified adjusted gross income (MAGI) exceeds IRS thresholds. These added charges apply to both Part B and Part D.

If you do pay IRMAA charges, the amount is calculated on a sliding scale with five income brackets. Figures are updated yearly with inflation and have a two-year lag time. To date, many policy insiders expect an increase in 2026 IRMAA amounts, but no hard figures are yet known.

Auto-renewal is coming for the MPPP

The Medicare Prescription Payment Plan (MPPP) allows enrollees to spread out their prescription drug costs across the year rather than paying large upfront amounts at the pharmacy.

In 2026, a new rule makes participating easier. If you opt in, you'll be automatically re-enrolled in future years unless you choose to leave.

You'll receive an annual notice of updated terms. If you do decide to exit the program, providers must process your request within the outlined timeframe.

Retirement News: Almost 80% of Americans fear a retirement age increase — here’s the real reason why

Supplemental benefits curtailed

Medicare Advantage plans have increasingly offered "extras" like meal deliveries, OTC benefits, transportation, and non-medical supports for chronic illness. But starting in 2026, new rules restrict services previously covered.

Plans will no longer be allowed to offer:

Non-healthy foods
Alcohol
Tobacco
Life insurance

These changes don't overhaul Medicare Advantage, but they do trim the perks, which may shift seniors' focus back to networks, drug coverage, and core benefits.

Prior authorization requirements are expanding

While historically Original Medicare requires prior authorization only for a small set of services, that's changing.

In 2026, Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington will pilot a new model expanding prior authorization requirements for several outpatient procedures.

These include:

Skin and tissue substitutes
Electrical nerve stimulator implants
Knee arthroscopy for osteoarthritis

Emergency and inpatient services remain excluded.

Prior authorization is already common in Medicare Advantage, but this is the first meaningful test of expanding it under Original Medicare.

Some dual-eligible seniors could lose Medicaid coverage

Medicaid requires states to verify enrollees' eligibility on a recurring basis, including reconfirming income and financial resources.

These verification checks can create administrative challenges, especially for people with complex health needs.

For Medicare-Medicaid "dual eligibles," losing Medicaid coverage can be especially harmful as Medicaid covers critical services such as long-term care and certain home- and community-based supports.

In 2023 Americans lost over $10 billion to identity theft and fraud

That's right. According to the FTC, Americans lost over $10 Billion to fraud and identity theft in 2023.

But you can safeguard your data with all-in-one identity theft protection services from Aura which comes with $1,000,000.00 in identity theft insurance¹ <p>Identity Theft Insurance underwritten by insurance company subsidiaries or affiliates of American International Group‚ Inc. The description herein is a summary and intended for informational purposes only and does not include all terms‚ conditions and exclusions of the policies described. Please refer to the actual policies for terms‚ conditions‚ and exclusions of coverage. Coverage may not be available in all jurisdictions.</p> per adult, to cover you should you have eligible identity theft-related losses.

An individual plan starts at $9 per month, and you can choose a family plan that outmatches most others - includes Dark Web monitoring to scour data breaches and leaks for your sensitive personal data — such as Social Security numbers (SSN), Medicare information, and phone numbers.

Before you make your next online purchase, protect what you’ve built for a fraction of what it could cost you if your data were compromised.

Save up to 68% when you sign up for protection today!

Some prescription drugs will see lower prices

For the first time, Medicare will enforce negotiated prices on a group of high-cost, single-source drugs starting in 2026.

The initial list includes Eliquis, Enbrel, Entresto, Farxiga, Imbruvica, Januvia, Jardiance, Fiasp/NovoLog, Stelara, and Xarelto.

Savings may be modest at first because the list is short, but more drugs will follow, including Ozempic, Rybelsus, and Wegovy in 2027.

Bottom line

Medicare beneficiaries face rising costs in 2026, especially under Part B.

Although Medicare trustees' projections haven't always been perfect, the broader trend is clear: health care costs are rising, and retirees will need to plan for greater out-of-pocket expenses to avoid medical debt.

If you rely on Medicare, 2026 is a year to review your situation carefully, check for IRMAA exposure, and budget for these changes if you want to continue to enjoy a stress-free retirement.

More from FinanceBuzz: