Medicare Got Reshuffled For 2026

1. Plan exits — the carrier reshuffle

Total non-SNP Medicare Advantage / MAPD plans dropped about 10% nationally — from 3,719 in 2025 to 3,373 in 2026. The big three carriers all pulled back:

Carrier	What they cut
Humana	Exited 3 entire states. Now in 46 (down from 49). Coverage dropped from 89% → 85% of US counties. Pulled from 194 counties total.
UnitedHealthcare	Exited 1 state. Pulled from 109 counties.
Aetna / CVS	Exited 1 state. Pulled from 100 counties.

Why? CMS reimbursement cuts plus medical-cost inflation made many MA plans unprofitable. Carriers also trimmed benefits on the plans they kept — smaller dental allowances, smaller OTC cards, narrower networks, higher max-out-of-pockets.

2. The new $2,100 Part D out-of-pocket cap

This is a real, hard cap. Once you hit $2,100 in true out-of-pocket drug costs, you pay $0 for the rest of the calendar year on any covered Part D drug. The cap was $2,000 in 2025; it adjusts for inflation each year.

Other 2026 Part D numbers:

• Max deductible: $615 (up from $590 in 2025)
• Coverage stages: just 3 now — deductible → 25% coinsurance → catastrophic ($0). The "donut hole" is gone for good.
• Catastrophic phase: kicks in at the $2,100 OOP cap. Used to require $8,000+ in spending. Massive change.

3. The Medicare Prescription Payment Plan (MPPP)

Brand new for 2025-2026: instead of paying drug copays in big lumps when you fill prescriptions, you can spread your annual Part D out-of-pocket costs across monthly installments, at no interest. The plan still pays the pharmacy directly; you pay the plan in monthly chunks.

Who benefits most:

• People with high drug costs early in the year (e.g., one expensive specialty drug starting January 1)
• People on fixed monthly budgets who'd struggle with a big lump payment

Who probably doesn't benefit:

• People with low total drug costs — you'd just be spreading small amounts thinly
• People close to the $2,100 cap already through other means

4. Medicare-negotiated drug prices kicked in

For the first time ever, the federal government negotiated prices on prescription drugs. New 2026 prices on the first 10 drugs:

Drug	Treats	Negotiated discount
Eliquis	Blood thinning	~56% off list price
Jardiance	Type 2 diabetes	~66%
Xarelto	Blood thinning	~62%
Januvia	Type 2 diabetes	~79%
Farxiga	Type 2 diabetes / heart failure	~68%
Entresto	Heart failure	~53%
Enbrel	Rheumatoid arthritis	~67%
Imbruvica	Blood cancers	~38%
Stelara	Plaque psoriasis / Crohn's	~66%
NovoLog / Fiasp insulins	Diabetes	~76%

If you take any of these, you should see a real reduction in what you pay at the pharmacy in 2026. Combined with the $2,100 cap, this is the biggest cost-relief moment in Medicare history for people on expensive drugs.

The next batch of negotiated drugs gets announced for 2027. The list grows over time.

5. Special Enrollment Period through Feb 28, 2026

What to do if you got a non-renewal letter

1. Don't panic, don't ignore it. You're auto-enrolled into Original Medicare on January 1 if you don't act, but that's usually not the best outcome.
2. Pull together: the non-renewal letter, your current medications list, your current doctors list.
3. Compare options: a different MA plan in your county, a Medigap + Part D combination, or staying on Original Medicare and accepting the gaps.
4. Decide before Feb 28. Otherwise you'll be locked into whatever default applies until next AEP (Oct 15 – Dec 7, 2026).

This is exactly the situation we help with. Free, no obligation.

6. Star Ratings — what changed

CMS overhauled how it rates Medicare Advantage and Part D plans for 2026. Some highlights:

• 11 measures eliminated (including some call-center measures)
• Cut points are stricter — many plans dropped a half-star not because care got worse but because scoring got tougher
• Patient-experience weight cut; outcome measures (BP control, diabetes A1c) weighted heavier
• New Health Equity Index rewards plans serving underserved groups