Medicare Advantage plans are becoming increasingly popular among seniors, with over 31 million Americans currently enrolled. These plans are a great way to receive healthcare coverage, as they often include benefits beyond what Original Medicare covers. However, as costs and coverage options change from year to year, it’s important for seniors to stay informed about the details of their Medicare Advantage plans 2026. In this article, we’ll discuss what you need to know about costs and coverage for 2026, including the average monthly premium, out-of-pocket maximum, and any new benefits being added.
What are Medicare Advantage Plans?
Medicare Advantage plans are offered by private insurance companies and provide an alternative to Original Medicare. These plans must cover all the services that Original Medicare covers, including hospital and medical insurance. Many Medicare Advantage plans also offer additional benefits, like dental, vision, and hearing coverage.
There are several types of Medicare Advantage plans, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Private Fee-for-Service plans (PFFS). Each type of plan has its own rules and requirements, so it’s important to understand the differences when choosing a plan.
Why Choose a Medicare Advantage Plan?
Many seniors prefer Medicare Advantage plans because they often provide more comprehensive coverage than Original Medicare alone. Some of the reasons why seniors choose these plans include:
- Lower out-of-pocket costs – Some Medicare Advantage plans have lower out-of-pocket maximums than what Original Medicare requires.
- Additional benefits – Many plans include extra coverage for services like dental, vision, and hearing care, which Original Medicare does not cover.
- Coordinated care – Medicare Advantage plans often offer coordinated care services, which can help seniors manage their health more effectively.
Estimated Costs for Medicare Advantage Plans in 2026
According to the Centers for Medicare & Medicaid Services (CMS), the average monthly premium for Medicare Advantage plans is expected to rise to $19 in 2026. This is a small increase from the current average of $18. The out-of-pocket maximum for these plans is expected to remain at around $5,000, which is significantly lower than the maximum out-of-pocket costs for Original Medicare.
These costs can vary significantly depending on the specific plan and the services covered. Seniors should carefully compare plans during the annual enrollment period to ensure they find the best option for their needs and budget.
Additional New Benefits in 2026
In addition to the expected cost changes, the Biden administration has announced that it will be expanding mental health services as well as enhancing coverage for chronic conditions. Starting in 2026, seniors will have improved access to mental health services, including:
- Coverage for up to 20 hours of mental health services per year
- Coverage for mental health services provided in-home
The administration is also working to ensure that seniors have better access to telehealth services, allowing them to receive care from the comfort of their own homes.
In addition, Medicare Advantage plans will also begin to enhance coverage for seniors with chronic conditions, including:
- Diabetes
- Heart disease
- Respiratory diseases
This will include more comprehensive care management programs as well as coverage for additional services such as nutrition counseling and wellness education.