MEDICARE UPDATE : 
News for 2026

Many changes for 2026
YOURE FIRST CHOICE IS THE MOST IMPORTANT!
Prescriptions drug plans, both in a Medicare Advantage plan and individual Part D prescription drug plan will have significant changes, It is Most important that you the consumer watch for your Annual Notice of Change  ANOC. This Document will be coming to you in late September or early October. It shows your current plan and premium and what the changes will be for 20256. WE are down to only 5 Compnies offering ONLY 12 differnt Prescription drug plans. /this change is impacting MANY Beneficiaries. Plans have gone away, formularies have changed and are limited and PREMIUMS  hve escalated. . 
Here are the three things we know now.
  1. 2026 Part D Deductible will be $615
  2. The Annual limit of your prescription cost will go down  from $6000 and will be capped at  $2100 Annually
  3. Insurance companies will offer a Payment plan due to the cost of some prescriptions
The Centers for Medicare and Medicaid services recently announced their cost adjustments for Parts A,B,C & D in 2026. For part B, the increases will be important for all beneficiaries.

Part A is going up to $  TBD
Part B premium is going to begin at  $185 and  up depending on your annual household income
Part B deductible is currently  $240 new cost will be released in November
Part D deductible will be $615 for 2026 and all but one plan has a deductible.

The increases in the Medicare Part B premium and deductible are due to:
  • Rising prices and usage by more seniors entering the market drive higher premiums year-over-year alongside anticipated increases in the intensity of care provided.
  
IRMMA 
INCOME RELATED MONTHLY ADJUSTED AMOUNT
You may be able to affect your IRMAA by altering your investment portfolio, which is something to discuss with your financial and tax advisors if you have some time before turning 65.

The LEP is calculated each year by Medicare using the annual base Medicare Part D premium, and the base premium


Remember, people in certain situations are not assessed a late-enrollment penalty, including:

  • People who qualify for Medicaid or the Medicare Part D financial Extra-Help program.
  • People who have some other form of creditable prescription drug coverage, such as VA, TRICARE, or employer/union drug coverage.


If you are on Kidney Dialysis, you need to read this:

Begininng in 2021 the only health question on a Medicare Advantage plan will be eliminated.
This means if you have End stage renal disease or you're on Kidney dialysis you will have the ability to join a MAPD Plan.

MAPD Plans are NOT Medicare supplements, These plans are called Medicare replacement plans and the
"  All in one " or "Pay as you go" Plan
To join
  • You must live in the service area (managed Care, HMO PPO) 
  • You must have Medicare Part A nd Part B 
  • There is a lock in period from April till December 
MORE updates
IF you are a diabetic and take insulin make sure you work with a professinal when choosing a Part D prescription Plan as new this year is a $35 insulin cap and here in Illinois of the 32 drug plans avaialable 7 companies are participating in the Insulin cap.
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I dont take any Medications but I heard that if I don't buy a part D plan I could  incur a lifetime penalty. COULD THIS BE TRUE?
 Yes it is TRUE
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I heard that your first Medicare health plan choice is the most important, why ?
When you are first eligible for Medicare you are guaranteed a plan regardless of your health situation. So if you have a family health history or perhaps you are a high utilizer of health benefits, you may want to consider a cost effective  plan. REMEMBER  after your General enrollment period you will have to answer health questions and you may not be able to join a Medicare supplement plan.

Question: I enrolled into a new Medicare Part D plan and still have not received my Member ID card. What should I do?
Category: Changing Medicare Part D Plans 

Answer: After enrolling in a Medicare Part D plan, the Medicare plan provider (such as Aetna or Humana) will need about 10 business days to send you a letter confirming your enrollment or a new Member "Welcome" package.
Medicare plans may then need up to five (5) weeks to send you a new Member ID card.
If you enroll late in the annual Open Enrollment Period (AEP - October 15th through December 7th), your Medicare plan provider may need a little extra time to process your enrollment due to the higher volume of activity.
If you are still waiting for your Member ID card to arrive, there are still several things you can do to use your Medicare Part D prescription drug coverage:
(1)  If you have received an enrollment confirmation or “Welcome” letter from your Medicare Part D prescription drug plan or Medicare Advantage plan, the letter should include your:
  • (1) Member ID number,
  • (2) PCN,
  • (3) Rx BIN, and
  • (4) Group ID (or Rx Group).



Places to go people to see

There are many choices 
You need a professional Insurance Agent to help you sort through all the information to find the plans that work for you and Your situation 

Individual and Family policies

Affordabale Insurance, it is available but you have to work with someone who can help you find the right policy that has your Physicians and Hospitals that you WANT.
NO healthplan regardless of the cost is valuable if you can't see your Doctor, or you can't afford the cost of using the plan because premium is low but nothing is paid till you pay down your Deductible.  You may qualify for a subsidy. Work with a professional, work with me, because keeping you healthy is important                                         Be Prepared 

Not everyone wants to fish!

Retirement can be a great time. Depending on your situation you may want to Travel, you may want to move to another state or become a snowbird,  or perhaps you want to spend  time  with your family and enjoy a hobby.  All these ideas are so important when you are healthy enough and finacially able to enjoy them. 
Let me show you the different ways you can protect yourself and all that you've worked for.