Newsletter

ANNUAL ENROLLMENT ENDS DECEMBER 7

The Annual Enrollment Period for enrollment into a Medicare Advantage, Medicare Advantage Prescription Drug, or stand-alone Part D Medicare Drug Coverage ends December 7.

After December 7, Medicare beneficiaries can enroll in a different Medicare plan only if they have a Special Enrollment Period or qualify to change plans during the Open Enrollment Period.

Beneficiaries can change Medicare Advantage or Medicare Advantage Prescription Drug plans or can return to Original Medicare with the option to add a Medicare Supplement and/or Medicare Drug Coverage during the Open Enrollment Period, which runs from January 1 through March 31. Agents are not permitted to market plans during this period, but a beneficiary can contact an agent and enlist the agent’s help during this period.

Beneficiaries who have been informed that their Medicare Advantage, Medicare Advantage, or stand-alone Part D Medicare Drug Coverage is being terminated have a special enrollment period to enroll in a new plan until February 28, 2026. These individuals also have a guaranteed issue right to enroll in a Medicare Supplement plan. Unless they enroll in a new plan by December 31, 2025, they will experience a break in coverage. If they don’t enroll by February 28, they won’t be able to enroll in a plan for 2026 (they will be enrolled in Original Medicare Parts A and B).

Medicare Supplement beneficiaries can change their Medicare Supplement plan at any time, BUT in most states (e.g., Florida), they must pass medical underwriting to enroll in a different plan. NOTE: eleven states have birthday rules which, while differing between states, permit beneficiaries to change plans without medical underwriting, while CT, MA, ME and NY permit changing plans at any time without medical underwriting.

Beneficiaries who have enrolled in a Medicare Advantage or Medicare Advantage Prescription drug plan as of the date they first became eligible for Part A of Medicare have a twelve-month “trial right” in which they can enroll in a Medicare Supplement plan (with or without stand-alone Part D Drug Coverage) without medical underwriting.

2026 MEDICARE PREMIUMS ANNOUNCED

The standard monthly premium for ALL Medicare Part B beneficiaries will be $202.90 for 2026, an increase of $17.90 from $185.00 in 2025.

Unless an individual has previously had to make an income-related monthly adjustment amount payment (IRMAA; see following) s/he is protected by a hold harmless agreement that guarantees the person cannot be charged an amount in excess of the amount of his or her Social Security increase. (Social Security benefits will increase 2.8% for 2026.)

Part B IRMAA

Since 2007, a beneficiary’s Part B monthly premium has been based on his or her income. These IRMAA amounts affect roughly 8% of people with Medicare Part B. The 2026 Part B total premiums for high-income beneficiaries with full Part B coverage are shown in this table.

Note: IRMAA applies to all Medicare beneficiaries who receive Part B benefits through Original Medicare with or without a Medicare Supplement plan, as well as to those who are enrolled in a Medicare Advantage or Medicare Advantage Prescription Drug Plan if their income (generally from the second previous year) equals or exceeds $109,000 (single individual) or $218,000 (married individual filing jointly).

Part D IRMAA

Since 2011, a beneficiary’s Part D monthly premium has been based on his or her income. Approximately 8% of people with Medicare Part D pay these income-related monthly adjustment amounts. These individuals will pay the IRMAA in addition to their Part D premium. Part D premiums vary by plan, and regardless of how a beneficiary pays their Part D premium, the Part D income-related monthly adjustment amounts are deducted from Social Security benefit checks or paid directly to Medicare. About two-thirds of beneficiaries pay premiums directly to the plan, while the remainder have their premiums deducted from their Social Security benefit checks. The 2026 Part D income-related monthly adjustment amounts for high-income beneficiaries are shown in this table.

Note: The Part D IRMAA is not payable unless the beneficiary is also enrolled in a Medicare Advantage Prescription Drug plan or stand-alone Part D Medicare Drug Coverage.

There is no premium for Medicare Part A (hospital) unless the beneficiary had less than 40 quarters of Medicare-covered employment, as determined by the Social Security Administration. Only about 1% of all Medicare beneficiaries must pay this premium.

Individuals who had at least thirty quarters of coverage or were married to someone with at least thirty quarters of coverage, may buy into Part A at a reduced monthly premium rate, which will be $311 in 2026, a $26 increase from 2025. Certain uninsured aged individuals who have fewer than thirty quarters of coverage, and certain individuals with disabilities who have exhausted other entitlements, will pay the full premium, which will be $565 a month in 2026, a $47 increase from 2025. 

Correction Regarding Medicare Supplements

The annnouncement that appeared in a prior newsletter concerning Hi Deductible Medicare Supplement plan (both HiG and HiF) deductibles and out-of-pocket maximums for Medicare Supplement plans K and L for 2026 was incorrect.

The correct deductible for the Hi Deductible plans for 2026 is $2,950, whereas the out-of-pocket maximum for Plan K is $8,000 and for Plan L is $4,000.

2026 MEDICARE PART A AND B BENEFITS

Medicare Part A covers inpatient hospital, skilled nursing facility, hospice, inpatient rehabilitation, and some home health care services. The Medicare Part A deductible and copays for 2026 will be in accordance with this table.

Medicare Part B covers physicians’ services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A. The Medicare Part B deductible will be $283 in 2026, an increase of $26 from the annual deductible of $257 in 2025.

The increase in the 2026 Part B deductible (as well as the premium) is mainly due to projected price changes and assumed utilization increases that are consistent with historical experience. The Part B premium increase would have been about $11 more a month had the Administration not taken action to address unprecedented spending on skin subsitiutes.. However, due to changes finalized in the 2026 Physician Fee Schedule Final Rule, spending on skin substitutes is expected to drop by 90% without affecting patient care. 

See this schedule that outlines the Medicare Part B coinsurance and deductible.

Note: The above changes will apply to beneficiaries on Original Medicare as well as those with Medicare Supplements. Any increase in deductibles or copays that are covered by a particular Medicare Supplement plan will be picked up by that Medicare Supplement.

Medicare Advantage/Medicare Advantage Prescription Drug beneficiaries will NOT be affected by these increases. 2026 Medicare Advantage and Medicare Advantage Plan benefits are paid in accordance with contracts that were signed before the start of the Annual Enrollment Period, and those contracts will not be adjusted to reflect these increases.

About Paul Cholak

Paul is a licensed, independent health and life insurance agent and has over forty years of benefits experience and specializes in helping Medicare beneficiaries obtain health insurance. However, he offers a complete array of life and health insurance products to individuals of all ages.

He guides Medicare beneficiaries through the steps of getting insurance and is available to help clients both BEFORE and AFTER they've made their purchase decision.

Disclaimer for Part C and D plans: "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY: 1-877-2048) to get information on all your options."

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