2026 Medicare Advantage Plans Premiums Headed Down

What to Expect in 2026

• Funding up ~4.33% (~$21B) to keep pace with medical inflation and utilization.

• Average premiums are down nationally, but your local market (competition, hospital rates, risk mix) drives your actual price.

• Legislative effects (e.g., Inflation Reduction Act drug provisions) continue to shape MA-PD pricing and benefits.

How to Compare Plans (Fast)

• Enter your ZIP in a trusted plan tool to see county-specific options.

• Compare side-by-side: premium, deductible, copays/coinsurance, OOP max, drug costs, and extras.

• Add your doctors, hospitals, and medications to see real projected costs at in-network providers and preferred pharmacies.

What Drives Premium Changes

• Medical inflation & new tech: New therapies and higher input costs pressure bids.

• Effective Growth Rate: Adjusts MA benchmarks based on FFS spending trends.

• Local dynamics: Provider contracts, plan competition, and rural vs. urban networks.

Why Prices Differ by Region

• Provider costs and market competition vary widely.

• Rural areas may see fewer plans and tighter networks; urban counties often have more $0 premium choices.

• Always compare at the ZIP/county level—national averages can hide big local swings.

Supplemental Benefits Outlook (2026)

• Many MA plans still include dental, vision, hearing, fitness, OTC.

• $35/month insulin cap and $0 cost-sharing for adult vaccines continue in MA-PD.

• Some carriers may trim certain extras in select areas to balance rising medical costs.

Regulatory & Carrier Responses

• Continued rollout of risk-adjustment and marketing guardrails.

• Some insurers consolidate or exit unprofitable geographies (especially certain PPOs); others double down where networks are strong.

• Translation: plan lineups change—don’t auto-renew without reviewing.

• List your needs: doctors, meds, hospitals, common services.

• Run a ZIP-based search: filter by providers and prescriptions.

• Compare total-year cost: premium + expected copays (up to OOP max) + drug spend.

• Enroll by Dec 7 to start new coverage Jan 1, 2026.

• Medicare Savings Programs (QMB/SLMB/QI/QDWI): Help with Part A/B costs if eligible.

• Extra Help (LIS): Lowers Part D drug costs for qualifying incomes.

• Ask an agent to screen you for state-specific assistance programs.

• Most MA plans include Part D; formulary tiers, preferred pharmacies, and utilization rules affect your drug spend far more than the plan premium.

• Medicare Prescription Payment Plan (MPPP): Lets you spread out drug costs across the year—opt in if cash flow matters.

Steps to Take Now

• Don’t rely on last year’s plan. Networks, drug tiers, and copays change.

• Model your annual cost using your real doctors and meds.

If you split time between states, weigh PPO flexibility vs. HMO savings.

Average Medicare Advantage premiums are poised to fall in 2026, but local realities still rule. Compare by ZIP, verify your providers and prescriptions, and judge plans by total annual cost—not premium alone.

👉 Call 1-833-641-4938 to compare 2026 MAPD options with a licensed agent. Get a side-by-side of your local plans, estimate real yearly costs, and lock in the right coverage for your budget and care.