Expect Skinnier Benefits, Higher Premiums and Fewer Options

Open enrollment for 2026 is underway. The Wall Street Journal reports Big Changes Are Coming for 2026 Medicare Plans. Note: That is a free link courtesy of the WSJ.

Last year, seniors picking Medicare coverage faced some tough choices. This year might be even worse.

The enrollment period for 2026 Medicare coverage starts Wednesday, and it is likely to be a difficult one for many enrollees. For the second year in a row, big Medicare insurers are getting rid of some plans, trimming popular benefits and increasing out-of-pocket costs such as deductibles.

The upshot: Seniors have to be careful, or they might end up with a bad surprise such as higher drug costs or the loss of a favorite doctor.

"This year is a nightmare," said Marcia Mantell, a retirement-planning consultant. Medicare enrollees "have to know more than they ever have had to know…it's all the hidden stuff," she said.

Behind the turmoil are business realities. Medicare insurers have seen their profits squeezed by higher-than-expected medical spending and regulatory changes. Now, some of the biggest are trying to improve their margins by dumping unprofitable products and by controlling costs better.

Higher costs

Medicare Advantage companies are increasing the maximum out-of-pocket cost in many of their plans. This figure is supposed to represent the total amount you could pay toward your care over the year, in the form of copayments and other charges. It is an important number to watch.

Wall Street analysts at Leerink Partners, analyzing a sampling of large 2026 plans, found that Medicare insurers including Elevance Health, UnitedHealthcare and CVS Health's Aetna were raising their average out-of-pocket caps. But Humana's is actually going down.