Medicare Advantage 2026: What You Need to Know About Costs, Coverage & Open Enrollment Changes
From lower prescription costs to reduced coverage areas, here's your guide to 2026 changes
Medicare open enrollment has officially closed, but Americans on a Medicare Advantage (MA) plan now have the option to switch up their coverage. And experts are warning this could be difficult now that some counties are no longer offering the service. Below we share what Americans can expect from the Medicare Advantage open enrollment period, including how much users can expect to spend in the coming year.
What is Medicare Advantage?
Medicare Advantage—also known as Medicare Part C—is an all-in-one insurance plan created by private insurance companies. It usually includes Part A (hospital coverage), Part B (medical coverage) and Part D (prescription drugs). It also normally has extra benefits such as dental and vision. Medicare Advantage plans are less expensive than traditional Medicare plans due to the fact that they have lower monthly premiums and built-in out-of-pocket maximums.
The downside? With that lower cost come network restrictions and referral rules, making it harder for people on the plan to get care.
How to qualify for Medicare Advantage
To qualify for Medicare Advantage you must first be eligible for normal Medicare, be enrolled in Parts A and B and live in a county where the service is accessible.
To check if your county is one of the eligible areas, Medicare.Gov recommends using their online tool, which you can access here.
When can you enroll in Medicare Advantage?
Americans can enroll in Medicare Advantage during the normal open enrollment period—which closed December 7. However, if you are one of the millions of Americans already on the plan, the Medicare Advantage Open Enrollment Period is open from January 1 to March 31.
During this time, users can switch to another Medicare Advantage plan or drop out of their Medicare Advantage plan and return to original Medicare. It’s important to note though, that during this enrollment period you can only make one change to your Medicare Advantage plan.
Because of that, experts urge people to do their research when enrolling or making changes, especially since the prices for Medicare Advantage are rising in 2026.
To help do that, experts recommend comparing your options, at Medicare.gov/plan-compare. Then, enter your ZIP code and select Medicare Advantage Plan (Part C) to explore your choices. Just keep in mind this tool isn’t perfect, cautions Feret. “Details like provider networks or real-time drug costs may be missing.” For in-depth help, visit ShipHelp.org to get free one-on-one counseling from a Medicare adviser.Or search online for an independent Medicare insurance agent who works with many carriers, he advises. Since their commissions come from the insurance companies, you’ll get their advice at no cost.”
How much will Medicare Advantage cost in 2026?
In 2026, Medicare Advantage users will have the choice to enroll in 32 Medicare Advantage prescription drug (MA-PD) plans. (In 2025, there were 34 options, but Aetna CVS Health, Anthem, Humana, UnitedHealthcare and Blue Cross Blue Shield are reducing their MA offerings in 2026.)
According to the Centers for Medicare & Medicaid Services (CMS) prices for the MA-PD plans will be based on income, work history and what plan you choose. In 2026, the costs will be as follows:
- Part D monthly premiums decrease from $13 to $11, and users will also be able to enroll in an automatic prescription payment plan that will help spread out prescriptions costs.
- The out-of-pocket expense limit for in-network services drops from $9,350 to $9,250.
With those lower costs comes less care, especially in Alaska, California, Colorado, Idaho, Kansas, Minnesota, Montana, Nebraska, Nevada, Oregon, South Dakota, Utah and Vermont, according to the nonprofit organization KFF.
“The two largest Medicare Advantage insurers—UnitedHealthcare and Humana—are exiting more counties—meaning they are no longer offering any plans in those counties–than they are entering in 2026,” they explained. “For example, UnitedHealthcare is exiting 225 counties, while entering 14 new counties and Humana is exiting 198 counties, while entering five new counties. Each insurer is offering plans in roughly 80 percent of all U.S. counties, a decline from 2025, when each insurer was offering plans in nearly 90 percent of counties.”
“Across all Medicare Advantage insurers that are exiting any markets, the set of counties that each Medicare Advantage insurer is exiting do not completely or in many cases, largely overlap,” KFF writes. “The different decisions of insurers to exit some counties suggest a combination of factors are at play, including local market characteristics, cost pressures, shifts in firm-level strategies and ultimately the insurers’ assessment of potential profits.”
