Medicare beneficiaries are in the annual open enrollment period from October 15 to December 7, when they can join or switch coverage. Federal projections suggest that 2026 will bring mostly familiar rules, but with some important changes in plan availability and costs.

Plan Choices May Narrow

The Centers for Medicare & Medicaid Services expects about 5,600 Medicare Advantage plans nationwide in 2026, roughly similar to this year but still part of a recent trend toward fewer options. The number of plans available can vary widely by state, and some insurers may trim service areas or benefits.

That could mean less flexibility for some people, though experts note that consolidation can also leave a smaller set of stronger offerings. As always, the outlook is based on estimates and plan details can change before coverage begins.

Costs Show Mixed Movement

Some costs are projected to rise while others ease. The average Medicare Advantage premium with drug coverage is expected to dip, while the average Part B premium is forecast to increase. Stand-alone Part D drug plans are also expected to become less numerous, though their average monthly premiums are projected to edge lower.

The annual cap on out-of-pocket spending for Part D prescriptions is set to rise slightly in 2026. Medicare officials will continue negotiating some drug prices, and insulin is expected to stay capped at $35 a month under Part D. Most vaccines should remain covered as well.

Other Factors To Watch

About 69 million people receive Medicare coverage, and most of the program’s basic structure is expected to stay the same in 2026. Still, the ongoing government shutdown could slow access to some Medicare services, adding another layer of uncertainty during enrollment season.

• Open enrollment runs from October 15 to December 7.
• Medicare Advantage plan choices may be slightly fewer in 2026.
• Average premiums are projected to move in different directions across plan types.
• Out-of-pocket drug spending limits will rise a little, while insulin and many vaccines remain covered under current rules.

People with questions about how these changes affect their own coverage should consult a qualified clinician or Medicare specialist.