Medicare Advantage Network and Cost Changes for AEP 2026

The Annual Enrollment Period (AEP) runs October 15 through December 7 each year, and 2026 has brought some of the most significant Medicare Advantage changes in recent memory. If you are enrolled in a Medicare Advantage plan — or considering one — understanding how networks, premiums, and out-of-pocket costs have shifted is essential to making a confident decision.

What Changed With Medicare Advantage Premiums in 2026?

Here is the headline that may surprise you: average premiums for Medicare Advantage plans with prescription drug coverage (MA-PDs) remain low. According to KFF, 75% of enrollees in individual MA-PD plans pay no premium beyond their Part B premium in 2026. The average supplemental premium across all MA-PD enrollees is $15 per month.

That said, premiums did tick up slightly from 2025. The average MA-PD supplemental premium rose from $13 per month in 2025 to $15 in 2026. For HMO enrollees, the average is $12 per month. For local PPO enrollees, it is $18 per month.

Meanwhile, standalone Part D prescription drug plan premiums actually decreased, falling from an average of $38.31 in 2025 to $34.50 in 2026. CMS took the unprecedented step of rejecting plan bids that included excessive premium increases, negotiating with carriers to bring costs down before approving contracts for 2026.

The takeaway: premiums are holding relatively steady for most beneficiaries, but the plans available to you may have changed. This is exactly why reviewing your options during AEP matters.

Are Medicare Advantage Provider Networks Getting Narrower?

This is one of the most important questions for anyone relying on a Medicare Advantage plan. Provider networks in Medicare Advantage plans have always been more limited than what you would find under Original Medicare, and in 2026, network changes are a real concern.

Medicare Advantage enrollees, on average, have access to roughly half of the physicians available to Traditional Medicare beneficiaries in their area, according to KFF research. More than half of Medicare Advantage beneficiaries are enrolled in HMO plans, which generally do not cover out-of-network services at all.

What does this mean in practice? If your doctor or hospital dropped out of your plan’s network for 2026, you may need to find a new provider or switch plans. Network changes happen every year, but the 2026 landscape has seen notable shifts as carriers adjust their business models in response to CMS regulatory pressure and rising costs.

Before AEP closes on December 7, verify that your current doctors, specialists, and hospitals are still in-network for your 2026 plan. A quick call to your provider’s office or a check on your plan’s website can save you from an unwelcome surprise in January.

How Did the Part D Out-of-Pocket Cap Change?

The Inflation Reduction Act introduced a $2,000 annual out-of-pocket cap for Medicare Part D prescription drug costs in 2025. For 2026, that cap has risen to $2,100. This cap applies to the total amount you pay out of pocket for covered Part D drugs during the year, including copayments and coinsurance.

While a $100 increase may not sound dramatic, it is worth noting — particularly if you take multiple brand-name or specialty medications. The cap also does not apply to Part A and B services, which have their own cost-sharing rules under Medicare Advantage.

The Part D deductible has also increased for 2026, meaning you may pay a bit more before your plan begins covering prescription costs. If your medication needs have changed, or if your current plan adjusted its formulary (the list of covered drugs), this is the time to compare your options.

What About Medicare Part B Premiums?

The standard Medicare Part B premium increased to $202.90 per month in 2026, up from $185 in 2025. That is roughly a 10% jump — and it consumes a meaningful portion of the Social Security cost-of-living adjustment for many beneficiaries.

Roughly one-third of Medicare Advantage enrollees are in plans that reduce the Part B premium as a supplemental benefit, most often by less than $10 per month. If minimizing your monthly costs is a priority, some plans may help offset part of that increase.

What Should You Do During AEP 2026?

AEP is your annual window to make changes to your Medicare Advantage coverage. Here is a practical checklist:

• Verify your providers. Call your doctors, specialists, and hospitals to confirm they remain in-network for 2026.
• Review your drug list. Check that your current medications are still covered and that your plan’s formulary has not changed in ways that affect you.
• Compare premiums and out-of-pocket costs. Even if your current plan looks similar on paper, a different plan in your area may offer better value for your specific needs.
• Check the out-of-pocket maximum. The average in-network out-of-pocket limit for Medicare Advantage enrollees is $5,421 in 2026. Plans vary — make sure you understand what your maximum exposure could be.
• Consider whether Medicare Supplement might be a better fit. If network restrictions and prior authorization requirements are frustrating, a Medigap plan paired with Original Medicare and a standalone Part D plan may give you more freedom to see any doctor who accepts Medicare.

Changes made during AEP take effect January 1, 2027.

The Bottom Line

Medicare Advantage continues to offer low or zero-dollar premiums for the majority of enrollees, and the Part D out-of-pocket cap provides meaningful protection against high drug costs. But 2026 has also brought narrower networks, rising Part B premiums, and more complex plan options than many beneficiaries have seen before.

The worst thing you can do is assume your current plan is still the right fit without checking. A few minutes of research during AEP — or a conversation with a licensed insurance advisor — can help you navigate these changes with confidence.

Trek Insurance Solutions is a Third-Party Marketing Organization (TPMO). We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Have questions about your Medicare Advantage options? Contact a licensed Trek Insurance Solutions representative at 888-960-0442 or visit trekis.net to schedule a no-obligation review of your coverage.