4 Things You Need to Know About Your Medicare Advantage Plan in 2026

Highlights

• Because Medicare Advantage plans differ from each other, it’s important to know your plan’s rules.

• Understand your costs and benefits.

• Learn what providers are available to you and know that you’ll have an out if you’re unhappy with your coverage.

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Once you turn 65, you are eligible for health insurance through Medicare. But you don’t necessarily have to stick with original Medicare.

Many seniors choose to enroll in a school Medicare Advantage plan instead of original Medicare. And doing so can have different benefits.

First, Medicare Advantage plans often offer benefits beyond the original. Medicare He will pay for it. Medicare Advantage plans also place a cap on annual out-of-pocket expenses. That’s huge at a time when you may be on a tight budget with Social Security benefits and modest retirement plan withdrawals.

But while Medicare tends to have the same rules for all enrollees, Medicare Advantage varies from one plan to the next. So whether you’re using a new plan or enrolled in the same plan in 2025, it’s important to know what your coverage covers and what rules you need to follow this year. Here are four things to keep in mind.

1. What do your costs include?

Medicare Advantage plans can change from year to year, which means your costs may decrease or increase. It’s important to know what costs you’re looking at in terms of premiums, deductibles, and co-pays so you can adjust your budget accordingly.

Keep in mind that you still have to pay for Medicare Part B every month, even if you’re on Medicare Advantage. However, some Medicare Advantage plans cover the Part B premium for enrollees.

2. What does your provider network look like?

One disadvantage of Medicare Advantage plans is that they limit enrollees to a specific provider network. With Original Medicare, you can see almost any doctor in the country who accepts Medicare.

Make sure you’re familiar with your plan’s provider network, because going out of network can leave you with very expensive costs. Also, if one of your providers was in network last year, don’t assume it will be the same this year. Medicare Advantage plan networks may change annually.

3. What additional benefits can you enjoy?

Another advantage of enrolling in Medicare Advantage is that these plans often offer additional benefits beyond what original Medicare pays. For example, you’ll often find that Medicare Advantage plans pay for dental care, eye exams, and hearing aids, but original Medicare does not cover these services.

Some Medicare Advantage plans offer even more benefits, like house cleaning services and meal delivery. It pays to see what extra benefits your plan provides. But before you get too excited about these benefits, you need to check the eligibility rules.

Your Medicare Advantage plan may offer meal delivery—but only if you have a medical condition that can be treated by making changes to your diet. And your plan may offer house cleaning—but only if you have asthma or a similar condition where cleaner air may lead to better lung health, depending on your diagnosis.

4. What options do you have to change your coverage?

At this point, it may be too early in the year to be fed up with your Medicare Advantage plan. But if you realize in the coming weeks that you chose the wrong plan or needed to make changes during open enrollment last fall, all is not lost.

Medicare Advantage has its own special open enrollment period that runs from January 1 through March 31 each year. If your current plan doesn’t seem to be working during this window, you can switch to a different Medicare Advantage plan. You can also drop Medicare Advantage and switch to original Medicare.

Find out your Medicare coverage early

As a retiree, healthcare can be one of your biggest expenses. And your private Medicare Advantage plan likely plays a role in how much you spend on it.

Make sure you’re familiar with your plan’s rules, costs, and benefits at the beginning of the year so you can get the most out of your coverage and avoid any unwanted surprises. And remember, you don’t have to stick to your plan through 2026, so if there’s a glaring aspect of your plan that you’re not happy with, don’t hesitate to make changes.

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4 Things to Know About Your Medicare Advantage Plan in 2026 originally published by The Motley Fool