Medicare

2026 Medicare: Are you game ready for Open Enrollment?

From October 15 through December 7, the Medicare Open Enrollment Period is your annual chance to take control and select the best health coverage. This is your critical window to review your current plan, explore new options, and prepare for the updates anticipated in the 2026 coverage year.

Think of Open Enrollment as your yearly coverage checkup. Just as a doctor's visit ensures your health is on track, this period ensures your plan is still the best fit for your needs and budget. A smart review now means you’ll be ready for January 1st with total peace of mind.

Let’s walk through the important updates and essential steps.

Key Medicare Updates You Need to Know for 2026

Every year brings adjustments to premiums, deductibles, and covered services. Here are the most important updates coming in 2026:

Premiums and Deductibles Are Rising

Costs for both Part B (doctor visits and outpatient care) and Part D (prescription drugs) are projected to increase in 2026. This isn't unusual, but these rising costs emphasize the importance of carefully reviewing your budget and plan details. Staying informed about these changes is essential to avoid unexpected out-of-pocket expenses.

The Drug Cost Cap is Moving Up

The catastrophic threshold for Medicare Part D—the annual limit on what you pay out-of-pocket for prescriptions—is increasing slightly to $2100. Also, there will be an increase in the deductible (projected to be $615)

Medicare Advantage changes to look out for

• There are several adjustments in 2026 for extra benefits like dental and Part B premium givebacks. Some plans may also no longer be available in California.

• Fewer companies are offering Medicare Advantage PPO plans.

• One of the major insurance companies does NOT have Cedars-Sinai and another does not have Providence Medical Group in their Medicare Advantage network next year. Knowing your network is critical. Please reach out to me to learn more.

5 Essential Steps for a Winning Coverage Strategy

The plan you have now might not be your best choice next year. Premiums, drug formularies, and benefits are constantly changing. Use these five steps to stay ahead:

1. Carefully Read Your Annual Notice of Change (ANOC): Your current insurer will send this document in the fall. Don't ignore it! It outlines all the changes for 2026, including costs, network adjustments, and covered services. Carefully review these details, as a plan you liked last year may no longer suit your needs.

2. Verify Medications and Coverage: Changes in drug prices and tiers mean your essential prescriptions could be moved to a higher cost tier or become uncovered. Check that all your medications are still covered and priced affordably under any plan you consider.

3. Confirm Your Care Network: Costs can rise significantly if your preferred doctor or hospital leaves the network. Verify that all your preferred providers and facilities are still in-network for 2026. Don't wait until you need care to find out you're out-of-network.

4. Plan for Future Health Needs: If you anticipate a specific surgery, treatment, or new medication in 2026, look at how different plans would cover those services now. Prepare ahead so you can choose the plan that offers the best support.

5. Contact Your Licensed Agent Early i.e EDSEL DSOUZA : While Open Enrollment runs until December 7, waiting until the final weeks often leads to rushing your decision. Be sure to contact me at your earliest.

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Don't wait until the final seconds to take your shot! In the game of coverage, proactive review is the championship mindset. Call me, Edsel Dsouza, now to finalize your winning plan and ensure a flawless start to 2026.

If you haven't already, please schedule a call me with me as soon as you are ready. If you are a new client or an existing client you can create your profile HERE. Click on the 'Get Synced' button at the top right after the link to begin.