Anna Wilde Matthews reports for the Wall Street Journal on some of the big changes to Medicare Advantage in 2026. Overall, people in Medicare Advantage will pay more, have fewer benefits, and less choice of physicians and hospitals. Look at your Medicare options carefully during this open enrollment season which began on October 15 and runs through December 7.
If you are in a Medicare Advantage plan, be sure to confirm that your plan is not ending, that the providers you want to use will be in-network and that your drugs are covered. (Some 1.2 million people in Medicare Advantage will need to find new Medicare coverage because their plans are ending.) Also, find out what your new costs will be. Insurers are ending many Medicare Advantage plans that offer more generous benefits in order to maximize their profits.
If you’re in a Medicare Advantage plan, take note of what your annual out-of-pocket maximum will be. That is rising. And, it can be more than $9,000 a year, although it is generally somewhat less than that. Matthews recommends looking at the Medicare Advantage plan’s benefits summary to find out hospital stay costs and monthly premiums. But, that won’t tell you what you really need to know.
You need to know whether the care you need will be covered from the specialists and hospitals you want to use. And, you can’t find that out. That’s why enrolling in a Medicare Advantage plan means gambling with your life.
If you are in traditional or original Medicare, which the government administers, you can see the doctors and hospitals of your choice and get the care you need without delays or inappropriate denials. If the cost of supplemental coverage in traditional Medicare is unaffordable, contact your members of Congress and let them know that you want the choice of traditional Medicare. Congress should be ensuring traditional Medicare is affordable to everyone with Medicare.
Here’s more from Just Care:
- Five things to think about when choosing between traditional Medicare and a Medicare Advantage plan
- Medicare Advantage delivers unreliable coverage
- Congressional Budget Office finds $1 trillion in Medicare Advantage overpayments
- Medicare Advantage: Expect lots of care denials
- Medicare Advantage plans continue to endanger hospitals and patients
- Medicare Advantage needs an overhaul
