Final Week of Medicare Open Enrollment: What to Know for 2026

Medicare beneficiaries should prepare for higher costs and fewer choices in 2026. Rising Medicare Part B premiums will affect all members. Meanwhile, some people will also face plan cancellations and shrinking options for prescription drug coverage.

What you pay for Medicare will likely change next year, and so might your coverage. It’s crucial to plan ahead so you can make any necessary adjustments to your coverage during open enrollment, which runs until Dec. 7. Here’s what to expect from Medicare in 2026.

Medicare Part B costs will go up

Medicare Part B, which covers medical and preventive care like doctor’s appointments, specialist visits and diagnostic tests, will be more expensive next year.

Medicare Part B will charge a monthly premium of $202.90 in 2026, up from $185 in 2025. The 9.7% increase is significantly larger than the 2.8% Social Security cost-of-living adjustment (COLA) for 2026, which is meant to account for a higher cost of living.

Medicare premium hikes have been stacking up in recent years, says Joanne Giardini-Russell, owner of the insurance agency Giardini Medicare in Michigan. The Medicare Part B premium was $144.60 per month in 2020. ”Now you go to $202.90, so that’s a pretty healthy clip,” she says.

Second, the Medicare Part B deductible you have to pay before Medicare starts to cover your costs will rise to $283 in 2026, up from $257 in 2025.

Your Part D premium could go up or down

The average premium for Medicare Part D prescription drug coverage is estimated to be $34.50 per month in 2026, down from $38.31 in 2025, according to the Centers for Medicare & Medicaid Services (CMS).

But premium increases for prescription drug plans are still widespread, with some enrollees facing an extra $50 per month or more, according to NerdWallet analysis of CMS data. Consumers in 11 states and Puerto Rico will lose access to $0-premium plans in 2026.

Beneficiaries facing a higher premium might be tempted to cancel their Medicare Part D plans, especially if they don’t take any prescription drugs. But Giardini-Russell warns against this. If you ever need to re-enroll, you could face a lifelong Part D late enrollment penalty — and that’s not the only risk.

“If they get diagnosed with something in the summertime, and they’ve not had a drug plan for two or three years, they’re gonna get walloped with some potentially big medical [costs],” says Giardini-Russell. If you’re diagnosed with a major illness in July and need to start taking medication, you could be stuck paying the full price until new coverage begins in January, which could easily cost thousands of dollars.

Giardini-Russell’s advice for people who don’t currently take any medications is to get the cheapest plan. “If it’s a $4.80 premium, get the $4.80 premium.”

You can shop around during Medicare open enrollment, which runs from Oct. 15 to Dec. 7 every year. The Medicare.gov plan finder tool is helpful for comparing plans in your area.

There are significantly fewer standalone prescription drug plans

There will be a total of 360 Medicare Part D plans offered across the country in 2026, down from 464 in 2025, according to health policy nonprofit KFF. In the past two years, the number of standalone prescription drug plans available to Medicare enrollees has been nearly cut in half. This shrinking market means fewer plan options for you.

“People will have an average of 11 plans from which to choose,” says Gretchen Jacobson, vice president of Medicare at the Commonwealth Fund, a private foundation focused on promoting a high-performing health care system. This is compared to 30 plans five years ago.

If your prescription drug plan is being discontinued, you may need to sign up for a new plan to maintain coverage, or you might be automatically enrolled in a similar plan by your insurance company. The plan you’re auto-enrolled in could have different premiums, out-of-pocket costs and covered drugs. It’s important to review your Annual Notice of Change and compare plans to make sure it’s still the best fit.

Plan cancellations offer a chance to switch to Medigap

A number of Medicare Advantage members are facing plan cancellations, according to Katy Votava, who holds a doctorate in health economics and nursing, and is president and founder of Goodcare, a consulting firm focused on the economics of Medicare.

UnitedHealthcare, the largest Medicare Advantage company, is shrinking its service area and discontinuing some plans in 2026, for example. And in Vermont, two Medicare Advantage companies pulled out of the market, leaving residents with only one option for Medicare Advantage companies in 2026.

But Votava sees these plan cancellations as an opportunity. “In most states, it’s hard for people to leave a Medicare Advantage plan and go on to a Medigap plan after their initial enrollment period for Medigap.”

But if your Medicare Advantage plan is cancelled, you’re granted temporary “guaranteed issue rights” that allow you to purchase a Medigap (Medicare Supplement Insurance) plan without underwriting. This means insurers can’t deny or charge you more based on your health, making it an ideal time to switch from Medicare Advantage to traditional Medicare with a Medigap policy if you can afford the higher premiums.

If you’re losing your Medicare Advantage plan, Votava encourages you to consider Medigap, especially if you have a lot of health care needs. “Medicare Advantage plans can be economical — anywhere from $0 to $50 or $60 a month — but they have a lot of copayments and coinsurance built into them.” You could end up spending up to $9,250 in 2026 on out-of-pocket costs with a Medicare Advantage plan.