By Christian Regalado
It’s that time of year, again, and we’re getting a clearer picture of what 2026 is going to look like in the world of personal health insurance. I’m writing this article in late September, and many of the new Medicare plans are just being released. As of October 1, brokers are allowed to discuss specifics about 2026 Advantage and prescription drug plans. The enrollment period runs from October 15 through December 7.. It would be advisable to make an appointment with a broker as soon as you can, since it will be a very busy time.
A change for 2026 is that most Medicare carriers that offer Advantage plans are choosing not to renew some or all of their PPO plans because they are less profitable due to out-of-network costs that they can’t control. If you are currently on a Medicare PPO plan, you may have to switch carriers to remain on a PPO or switch to an HMO plan that won’t have out-of
network benefits but may have “Travel Passport” benefits. These are benefits allowing you to use the carriers’ national or regional network.
Referrals are also going to be required by one carrier on their HMO plans to help reduce costs.
By now, you should have received your Annual Notice of Change and if you have been advised that your plan will be cancelled, you need to enroll in a new plan for 2026 by December 31. If you don’t, you will only have original Medicare starting January 1t. Because of this disruption and plan elimination, online brokers (800 brokers) will be very active trying to collect your information and attempting to enroll you in a new plan. Be careful, their incentive is not always to enroll you in the plan that is best for you which accepts your doctors and hospitals. Use a local broker who is familiar with plans that are accepted locally.
If you have any dental needs coming up, be sure to be familiar with your plan’s dental benefit for 2026. This will vary plan to plan, and many dental
benefits have been cut, so keep that in consideration when deciding which plan will make the most sense for 2026.
Medicare Supplement plans are not included in the Annual Enrollment Period (AEP). However, your prescription drug plan is, and there will be many changes in these plans in 2026 due primarily to increased drug costs. There will be PDP plans with a $0 monthly premium, but expect a high drug deductible. Depending on your prescriptions, it may be cost-effective to pay some premium for a plan that covers your prescriptions. There will also be a price reduction on ten expensive drugs, such as Eliquis and Januvia. These savings can be as much as 75%.
Open enrollment for those under 65 starts November 1. The 2026 plans haven’t been released as of this writing, and big questions remain regarding tax credits. If the tax credits go away or are severely reduced, many people may not renew their plans due to lack of affordability. I will probably know more by the time you read this, but I don’t expect good news. If this affects you, don’t go without any type of coverage. There are low-cost plans that provide some reimbursement benefits for emergencies, critical illnesses, and hospital stays.
Give us a call, and we can help you sort out the best 2026 options for you. Our services are always free of charge, and there is never an obligation to change plans. I am available to speak with you anytime and there is no fee to you for my services. If I can help, please reach out! We can chat over the phone or meet in person. I’m happy to help! Email Christian@evergreenhealthins.com or call (850) 687- 7606.
