Millions of seniors with Medicare Advantage plans can expect slimmed-down benefits, loftier premiums, and a reduced selection of options in 2026 plans.
What that means: This is not the year to skip reviewing your coverage during open enrollment, which kicked off this week.
In September, you received your Annual Notice of Change letters spelling out changes in coverage and costs that will be effective next year. The open enrollment period runs through Dec. 7. During this time, those who are enrolled can make modifications to their coverage, which goes into effect on Jan. 1. You can switch between original Medicare and Medicare Advantage, change Medicare Advantage plans, and add or switch your Part D prescription drug plan. And possibly add or change to a new Medigap policy.
Medicare Advantage is an alternative health insurance program to traditional Medicare for those 65 and older. The plans are run by private insurance companies such as UnitedHealthcare and Humana and have been soaring in popularity.
However, for 2026, some insurers are jettisoning plans, hospital systems, and doctors, paring back benefits and ramping up out-of-pocket costs, including deductibles.
“Some insurers are deemphasizing or even pulling out of certain geographic markets,” Philip Moeller, a Medicare and Social Security expert, who writes the Aging in America newsletter, told Yahoo Finance. “Variations among plan premiums, co-pays, and annual deductibles are unusually large, leading to large differences in out-of-pocket costs among plans.”
Case in point: UnitedHealthcare and Johns Hopkins Medicine ended their network contract in August. That means that most Johns Hopkins facilities and providers are now out of network for patients with UnitedHealthcare Medicare Advantage plans. “If your Johns Hopkins Medicine hospital doesn’t participate with a Medicare Advantage Plan, you can use out-of-network benefits if your plan has them,” according to the healthcare provider’s website.
Read more: Medicare open enrollment: How to add or adjust your coverage
More than half of eligible beneficiaries have enrolled in Medicare Advantage since 2023, according to KFF. A big sweetener is the perks not included in traditional Medicare, such as drug coverage (Part D), eyeglasses, dental coverage, gym memberships, and reimbursements for — believe it or not — bowling balls and pickleball paddles.
Plus, they often have very low or even no premium costs.
There are disadvantages. Most Medicare Advantage plans require prior authorization as a condition for coverage of services, a restriction only rarely required in traditional Medicare.
Unlike original Medicare, depending on the Advantage plan, you’re limited to a specific network of doctors and other healthcare providers, and those networks are often in flux from year to year.
It’s not unusual to be referred to a specialist who is not part of your Medicare Advantage plan network. In those cases, you need prior authorization to make an appointment, or simply be prepared to pony up and pay the bill out of pocket.
Here are the 2026 Medicare Advantage plan changes you need to know.
Let’s start with getting accurate information.
Medicare’s online searchable Plan Finder on the Medicare.gov site allows you to review Medicare Advantage plan options. Every fall before open enrollment, Medicare loads all of the private plan data into this tool, including Part D drug plans, private Medicare Advantage plans, and even the Medigap plans, which are run by the states.
“New Medicare reporting rules for MA plans will allow consumers to see more details about the plans’ supplemental benefits and, for the first time, the names of doctors, hospitals, and others in the plans’ medical provider networks, Moeller said.
In the past, to get that information, you had to go to each plan’s website or call each company or your doctors to see if they were part of the plan.
That’s super, in theory. “Insurers’ provider directories have contained many mistakes in the past, and there have already been accounts of mistakes in the new publicly accessible directories,” Moeller said.
Meanwhile, the Centers for Medicare & Medicaid Services (CMS) website states that due to the government shutdown, “updates to information on this website may be limited or delayed.”
CMS has flagged consumers and has a plan to address the bad information. If you make your 2026 MA plan selection on directory information that turns out to be wrong, you can change your choice during the first three months of the year.
“To be safe, enrollees should call their preferred health providers to confirm they will be authorized to treat you next year,” Moeller said. “Also, call health insurers to confirm details of any 2026 plans before enrolling.”
Across all Medicare Advantage plans for individual enrollment, including those with and without prescription drug coverage, the average Medicare beneficiary has the option to choose among 39 plans in 2026, compared to 42 options in 2025, per KFF.
But that slightly lower number of options belies the larger trend.
More than a million Medicare Advantage enrollees may lose their current plans next year because the plans are being shuttered due to higher medical costs and outpatient care.
Expect this shrinkage to continue.
If you do nothing when you receive the notice, you’ll be enrolled in a replacement plan, but there’s no guarantee your favorite doctors will be on it. If the company is leaving the market altogether, you would have to sign up for a new Medicare Advantage plan if you want to stay in Medicare Advantage or switch to traditional Medicare for next year.
To cut their costs, Medicare insurers might be pushing yours up.
Although many seniors focus on no-premium Medicare Advantage plans, the real priority should be total healthcare costs, Jae Oh, author of “Maximize Your Medicare,” told Yahoo Finance.
“The key factor, beyond premiums, is the annual out-of-pocket maximum — the point at which the insurer covers 100% of remaining costs.”
“$0-premium plans still exist, but the era of the truly ‘no-cost’ plan is fading,” he said. Some insurers are now adding health or drug deductibles, making it harder for beneficiaries to compare options.”
The average monthly plan premium across all MA plans, which includes MA plans that provide prescription drug coverage and MA Special Needs Plans (SNPs), is estimated by CMS to decrease from $16.40 in 2025 to $14.00 in 2026.
That said, that’s the average. Some Medicare Advantage companies are charging more than that and increasing the maximum out-of-pocket cost in many of their plans. This figure is supposed to represent the total amount you could pay toward your care over the year, in the form of co-payments and other charges. It is a vital number to watch.
The government provides an upper limit, but insurers offer plans with a range of caps. In 2026, Medicare Advantage plans can’t exceed $9,250 for in-network services or $14,750 for combined in- and out-of-network services.
For 2026, experts say that some Medicare Advantage plans are shaving their dental and vision coverage, for example, and raising co-pays to see specialists. If you signed up for a gym membership through a Medicare Advantage plan, it may not be available next year.
“Supplemental benefits, such as dental, vision, and gym memberships, should be taken into consideration, but only after ensuring that the plan will provide affordable medical coverage and access to the doctors, hospitals, and medications that the person needs,” Louise Norris, health policy analyst for medicareresources.org, said.
She said it’s critical to review the plan’s rules for things like prior authorization and step therapy, where a plan requires you to try a lower-cost prescription drug that treats a given condition before “stepping up” to a similar-acting but more expensive drug if the lower-cost medication has failed to treat the patient’s condition.
Sadly, one other change coming in 2026 is that many of those enrolled in Medicare Advantage plans, who have chronic illnesses and limited incomes, may no longer be eligible for an array of extra benefits when a pilot project is cut off next year due to high costs.
The Medicare Advantage Value-Based Insurance Design Model, with 62 plan sponsors participating in 2025, provided benefits, such as less pricey prescription drug costs, food assistance, rides to medical appointments, and support to help manage chronic health conditions to over 7 million beneficiaries. It was aimed at low-income beneficiaries — those dually eligible for Medicare and Medicaid and who qualify for Medicare’s Extra Help program, which lowers prescription drug prices.
Have a question about retirement? Personal finances? Anything career-related? Click here to drop Kerry Hannon a note.
The State Health Insurance Assistance Program network (SHIP) provides one-on-one counseling in every state. You can find your local SHIP here.
The Medicare Rights Center offers a free consumer helpline: 800-333-4114. You can also contact Medicare directly at 800-633-4227 to find Medicare Advantage and Part D Plans in your area and to enroll directly.
Medicare’s online searchable Plan Finder on the Medicare.gov site allows you to review Medicare plan options.
The National Council on Aging has a free helpline (1-800-794-6559) to assist you in navigating Medicare.
If you have a limited income, you might be eligible for Medicare’s Extra Help, which covers Part D premiums and deductibles and caps drug costs.
Kerry Hannon is a Senior Columnist at Yahoo Finance. She is a career and retirement strategist and the author of 14 books, including the forthcoming “Retirement Bites: A Gen X Guide to Securing Your Financial Future,” “In Control at 50+: How to Succeed in the New World of Work,” and “Never Too Old to Get Rich.” Follow her on Bluesky.
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