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More than a third of Medicare Advantage and Part D enrollees are unaware of significant cost and benefit changes coming in 2026, according to a survey from eHealth.
The findings highlight widespread confusion as millions of Americans prepare to review their coverage during this year’s Annual Enrollment Period, which runs from Oct. 15 through Dec. 7.
The survey, which gathered responses from more than 1,500 Medicare beneficiaries, found that 75% find choosing a Medicare plan confusing.
Despite major program adjustments expected next year, only 51% of respondents plan to review their coverage options this fall, down from 63% who did so last year.
WHY THIS MATTERS: WHAT’S CHANGING
Whitney Stidom, vice president of consumer enablement at eHealth, told Healthcare Finance News the most significant changes include increased monthly premiums or out-of-pocket costs, such as higher deductibles, and the elimination of some Medicare Advantage plans entirely.
Other recent changes include the creation of the Medicare Prescription Payment Plan, which enables beneficiaries to spread out the cost of prescription drugs over the entire year. Some states are starting to use prior authorization requirements to help lower healthcare costs.
“If beneficiaries enrolled in Medicare Advantage and Part D plans haven’t already done so, now is the time to review their annual notice of change letter that insurers sent out in September,” Stidom says.
These letters outline specific changes to individual plans, including adjustments to supplemental benefits and monthly premiums, deductibles, copays or coinsurance.
She said other potential adjustments to look for include what drugs are covered and at what price, and changes to which medical providers are considered in-network.
“The annual notice of change letters are sent out each year to everyone enrolled in a Medicare Advantage or stand-alone Medicare Part D plans,” Stidom says. “That’s over 57 million people.”
Unfortunately, many people may see a letter from their insurance company and ignore it. In fact, 24% of Medicare Advantage enrollees said they don’t ever recall receiving one of these letters.
“If beneficiaries haven’t received their Annual Notice of Change letter, or misplaced it, they should contact their Medicare insurance company directly for another copy or for a summary of how their plan coverage is changing in 2026,” she said.
THE LARGER TREND
Survey results suggest that many seniors may enter the 2026 plan year unprepared for changes in cost structures and benefits. Many Medicare beneficiaries continue to struggle with basic program understanding and benefit awareness.
One in three respondents said they do not have a clear grasp of how Medicare Advantage, Medicare Supplement and Part D plans differ — an ongoing source of confusion that can affect plan selection and out-of-pocket costs.
Another third incorrectly believe Medicare covers GLP-1 drugs for weight loss, despite current limits on such coverage.
In addition, 29% of respondents were unaware that Medicare fully covers recommended vaccines with no out-of-pocket expenses.
Looking beyond 2026, Stidom says the Medicare market will continue to evolve, with continued enrollment growth in Medicare Advantage plans expected in the coming years.
“We are also seeing a greater focus on value-based care, which aims to reward care providers for delivering quality,” she said.
Technology will also play a bigger role in how consumers shop for and use their Medicare benefits, including advances in AI.