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Costs and choices shift for upcoming Medicare coverage
Seniors selecting Medicare coverage for 2026 will see modest but notable changes in premiums, fewer plan options, and reduced prescription drug choices, according to the Centers for Medicare & Medicaid Services (CMS). Open enrollment continues through Dec. 7, 2025.
CMS projected the average monthly premium for Medicare Advantage plans will fall to $14 in 2026, down from $16.40 this year.
In Illinois, nearly 2.5 million Medicare enrollees will see their average monthly premium rise slightly, from $8.10 in 2025 to $8.51 in 2026.
CMS estimates Medicare Advantage enrollment will drop to 34 million in 2026, down from 34.9 million in 2025. That represents approximately 48% of all Medicare enrollees, compared with 50% this year. The drop is due in part to some insurers consolidating or discontinuing plans, which may reduce options in certain counties.
Illinois beneficiaries will have access to 157 Medicare Advantage plans in 2026, down from 165 in 2025. All residents with Medicare will have at least one plan option, including $0 premium plans.
Rising costs and fewer choices
The standard Medicare Part B premium will rise to $206.50 in 2026, up from $185 this year, and the annual deductible could increase to nearly $260, according to AARP. Emily Nabors, associate director of innovation at the National Council on Aging, calls the increase “significant.”
“It’s going up 12%, from $185 monthly to $206.50,” Nabors says. “You multiply that by 12, and that’s substantial. There are also increases to inpatient hospital copayments and Part D drug coverage deductibles, and changes from flat-rate charges to coinsurance. That means people could pay a share of the drug cost instead of a fixed amount.”
The average basic Part D premium for prescription drug coverage will increase to $36.78 per month, compared with $34.70 this year, according to CMS projections. And beneficiaries in some states will have fewer than five Medicare Advantage plans with prescription drug coverage, including none in Alaska, four in South Dakota, three in Wyoming, and one in Vermont, reports the Kaiser Family Foundation.
An Associated Press analysis found that the average number of stand-alone Part D drug plans has fallen from nearly 30 in 2021 to between 8 and 12 in most markets.
Illinois residents will have access to 12 stand-alone Medicare prescription drug plans in 2026. All residents will have access to at least one plan with a lower premium than in 2025. Some Medicare Advantage plans that previously offered extra benefits — such as transportation, food assistance, or chronic care management — are ending those options due to rising costs, Nabors says.
Check before you renew
CMS advises beneficiaries to carefully review their annual notice of change documents, as plan premiums, cost-sharing, and covered benefits may differ from this year’s coverage.
“Even if you’re not planning to change plans, it would be smart to compare options in your area and check any annual notices of change you might have received,” Nabors says. “Some plans may be discontinued or have new networks or benefits.”
Millions of beneficiaries will continue to have access to affordable options, according to CMS Administrator Mehmet Oz, MD, in an October 2025 press release. “We want every beneficiary to take advantage of Open Enrollment — compare your options, and choose the plan that gives you the right care at the best price.”
Beneficiaries can compare plans and estimate costs using the Medicare Plan Finder or get free one-on-one assistance through their State Health Insurance Assistance Program (SHIP). Nabors also says the National Council on Aging’s BenefitsCheckUp tool helps older adults find and apply for financial assistance programs.
And remember: Don’t assume this year’s plan is still the best fit. “Many people just renew automatically,” Nabors says. “But this would be a good time to make sure what you have is right for you and explore potential options.”
