How to Cut Your 2026 Medicare Costs During Open Enrollment

Open enrollment for 2026 Medicare coverage is one of the most consequential financial decisions you will make all year, yet millions of beneficiaries skip the process entirely and simply let their current plan auto-renew. That habit can be expensive. Plans change their premiums, deductibles, formularies, and provider networks every single year, and a plan that was the right fit in 2025 may cost you hundreds — or even thousands — more in 2026 if you stay without checking. The Annual Enrollment Period, which runs from October 15 through December 7 each year, is your guaranteed window to compare and switch without penalty.

The single biggest policy change affecting 2026 Medicare drug costs is the $2,000 out-of-pocket cap on Part D prescription drug spending, a provision of the Inflation Reduction Act that fully takes effect in 2026. Before this change, there was no hard ceiling on what you could spend on drugs in a given year — the old "catastrophic" threshold required you to spend thousands before coverage kicked in at a higher rate. Now, once your total out-of-pocket drug costs hit $2,000 in a calendar year, your Part D plan covers 100% of covered drug costs for the rest of the year. For beneficiaries who take expensive specialty medications or multiple brand-name drugs, this cap can represent thousands of dollars in annual savings. But it also means you need to re-evaluate which Part D plan — whether standalone or embedded in a Medicare Advantage plan — best positions you to reach that cap efficiently.

Alongside the out-of-pocket cap, 2026 also brings changes to how the Part D deductible works. The standard Part D deductible for 2026 is $590, up from $545 in 2025. Not every plan charges the full deductible — some plans waive it entirely for certain drug tiers, particularly generics — so comparing deductible structures across plans in your area is a meaningful way to reduce early-year costs. The Medicare Plan Finder tool at Medicare.gov allows you to enter your specific medications and dosages, then see a side-by-side estimate of your total annual drug costs under each available plan, including premiums, deductibles, and copays. Using this tool with your actual drug list is far more reliable than choosing a plan based on the monthly premium alone.

For beneficiaries enrolled in Original Medicare — traditional Part A and Part B — the 2026 standard Part B premium is $185.00 per month, up from $174.70 in 2025. The Part B deductible is $257 in 2026. These costs apply to everyone in Original Medicare and to those in Medicare Advantage plans, since Advantage plans require you to remain enrolled in Part B. If your income is above certain thresholds, you will also pay an Income-Related Monthly Adjustment Amount, or IRMAA. In 2026, IRMAA surcharges begin for individuals with modified adjusted gross income above $106,000 (or $212,000 for married couples filing jointly), and can add anywhere from roughly $70 to over $400 per month to your Part B premium depending on your income bracket. If your income dropped significantly in 2024 or 2025 due to retirement, a spouse's death, or other life event, you can appeal your IRMAA determination using IRS Form SSA-44 — this is a step many beneficiaries overlook.

If you are currently in Original Medicare with a Medigap supplemental policy, open enrollment season is a good time to review whether your Medigap plan still makes financial sense. Medigap Plan G remains the most comprehensive option available to new enrollees in 2026, covering the Part A deductible ($1,676 per benefit period in 2026), coinsurance, and most other gaps except the Part B deductible. Plan N is a lower-premium alternative that requires small copays at doctor visits and does not cover Part B excess charges. Premiums for the same Medigap plan can vary by hundreds of dollars annually depending on the insurance company and your state, so comparing prices through your State Health Insurance Assistance Program, or SHIP, counselor is worthwhile. Unlike Medicare Advantage or Part D, switching Medigap plans outside of a guaranteed issue window typically requires medical underwriting, meaning insurers can charge you more or deny coverage based on health conditions. The exception is if you live in one of the states with a birthday rule — California, Idaho, Illinois, Kentucky, Louisiana, Maine, Maryland, Missouri, Nevada, New Jersey, New York, Oklahoma, or Oregon — where you have a 30-day window around your birthday each year to switch Medigap plans without underwriting.

For those considering a move from Original Medicare to Medicare Advantage, or switching between Advantage plans, the AEP is the primary opportunity to do so. Medicare Advantage plans in 2026 continue to offer benefits beyond Original Medicare — such as dental, vision, hearing, and fitness programs — but the scope of these extras varies enormously by plan and county. Some plans that offered rich supplemental benefits in prior years have scaled back in 2026 as CMS tightened its payment rules. Before switching to an Advantage plan for the extras, verify that your primary care doctor, specialists, and preferred hospital are all in-network for 2026, since networks are renegotiated annually. A plan that included your cardiologist in 2025 may not include them in 2026. You can verify provider participation directly through each plan's online directory or by calling the plan.

If you miss the AEP deadline of December 7, you are not entirely without options. The Medicare Advantage Open Enrollment Period runs January 1 through March 31 each year, allowing people already enrolled in a Medicare Advantage plan to switch to a different Advantage plan or return to Original Medicare once during that window. However, this period does not allow you to enroll in a standalone Part D plan if you are moving to Original Medicare without also picking up a drug plan — so act promptly if you use that window. Special Enrollment Periods are also available for qualifying life events such as moving to a new service area, losing employer coverage, or qualifying for Extra Help with drug costs.

Extra Help, also called the Low Income Subsidy, is a federal program that reduces or eliminates Part D premiums, deductibles, and copays for beneficiaries with limited income and assets. In 2026, individuals with income up to roughly 150% of the federal poverty level — approximately $21,500 for a single person — may qualify for full Extra Help benefits. Many eligible beneficiaries never apply. You can apply through the Social Security Administration at ssa.gov or through your local SHIP office at no cost. State-based Medicare Savings Programs can also help pay your Part B premium and cost-sharing, with eligibility thresholds varying by state. Contacting your State Medicaid office or a SHIP counselor before the AEP closes can help you determine whether you qualify for assistance you have not yet claimed.

The most practical step you can take right now is to pull out your current plan's Annual Notice of Change letter, which all Medicare plans are required to mail to enrollees by September 30 each year. This document spells out every change to your plan's premiums, deductibles, copays, and formulary for the coming year. Read it alongside the Medicare Plan Finder at Medicare.gov, and if you want personalized, unbiased help, contact your local SHIP program — counselors are free, trained, and have no financial stake in which plan you choose. The SHIP locator is available at shiphelp.org. Taking two hours during the AEP window to compare your options could easily save you $500 to $1,500 or more over the course of 2026.