Medicare 2026: Understanding This Year’s Updates and Why a Plan Review Matters
Each year, Medicare updates its rules, costs, and coverage options. These adjustments help maintain the program’s long-term stability but can also affect how much you pay or which doctors and prescriptions your plan covers. The Annual Enrollment Period (AEP), held each fall from October 15 through December 7, gives beneficiaries the opportunity to review and adjust their coverage for the upcoming year.
As 2026 approaches, it’s worth taking time to understand what’s changing and how those changes might impact your healthcare and budget.
Key Medicare Changes in 2026
Several updates are expected in 2026 that could influence the decisions of Idaho seniors. The Part B deductible will rise again, moving from $255 to $288
, and some Medicare Advantage carriers are leaving the Idaho market. When a carrier exits, affected policyholders may qualify for a Special Enrollment Period (SEP) to select a new plan.
These changes can alter your monthly costs, available networks, and prescription drug coverage, even if your plan name remains the same. It’s a reminder that Medicare is not static. Annual adjustments can significantly influence your coverage.
Medicare Advantage (Part C) plans often appeal to beneficiaries because of their low or $0 monthly premiums. However, these plans include copays and maximum out-of-pocket (MOOP) limits that vary by provider. Meanwhile, Medicare Supplement (Medigap) plans such as Plan G tend to have higher premiums but offer more predictable coverage and fewer out-of-pocket surprises. Understanding which plan type best matches your medical needs and financial situation is an essential part of effective retirement planning.
Why Reviewing Your Plan Each Year Is Important
Many retirees assume their existing plan will continue to meet their needs, but that’s not always the case. Plan networks, prescription formularies, and out-of-pocket limits can all shift from year to year. Medications you rely on could move to a higher-cost tier, or your preferred doctor might no longer participate in your network.
Conducting an annual review helps ensure your plan still fits your current health status, prescription needs, and financial goals. Idaho residents also benefit from the Idaho Birthday Rule, which allows those with Medigap coverage to switch to another plan of equal or lesser benefits within 63 days of their birthday without medical underwriting. This offers flexibility if your premiums have increased or if you wish to explore alternative coverage.
Getting Reliable Guidance
Medicare rules can be complex, and small errors, such as missing your Initial Enrollment Period when you first turn 65, can result in lasting financial penalties. Licensed Medicare representatives can help explain plan options, enrollment timelines, and annual updates. Their services are free to beneficiaries because representatives are compensated by insurance carriers, not by clients.
Having someone walk through the details with you can simplify the process and help you make informed, timely decisions about your coverage.
Take Time Before December 7
Whether you’re new to Medicare or have been enrolled for years, this year’s updates are a reminder that healthcare planning is an ongoing process. Reviewing your plan before December 7 ensures you understand what’s changing, what your options are, and whether a different plan may better meet your needs for 2026.
For a deeper discussion about this year’s updates, listen to the latest episode of the Senior Matters Podcast with host Mark E. Wight and guest Chad McDonald, Medicare Specialist at CRM Group, LLC. They explore how 2026 changes could affect Idaho residents and offer practical advice for making confident, informed choices during this enrollment season.
🎧 Listen now to the episode or visit Seinor Matters Podcast to learn more.
