What is happening to Medicare Advantage plans in 2026?
Medicare Advantage plans in 2026 are introducing several key consumer-focused enhancements and structural adjustments. A major change for the year is the implementation of a new annual out-of-pocket cap of $2,100 for all Medicare Part D-covered drugs, along with the introduction of negotiated prices for select high-cost medications. In-network out-of-pocket maximums for Medicare Advantage plans are set at $9,250, though most plans cap these costs much lower. Other updates include mandatory parity for behavioral health cost-sharing, ensuring these services are no more expensive than under Original Medicare, and an automatic annual renewal process for the Medicare Prescription Payment Plan (MPPP), designed to improve budget predictability for beneficiaries managing chronic conditions.
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