2025 AEP is Over! 2026 Changes

AEP is in the books. This is the time to make plan changes to Medicare Advantage Plans (MAPD) or Prescription Drug Plans (PDP). 2026 is bringing many changes so it was a challenging year for consumers to make decision.

Here in Ohio, we had several plans that were terminated altogether, meaning the enrollee HAD to make a change, otherwise they would be put on Original Medicare come January 1, 2026. Luckily Medicare has many safety nets and a person affected by this has until February 28, 2026 and even gets a Guaranteed Issue Right to select any other plan, including a Medicare Supplement.

The prescription drug market continued to play a massive role. People with standalone prescription drug plans (PDP) were largely directed to self-help tools to select a plan. There were also far fewer options. In 2024, Dayton Ohio had 22 prescription drug plans available. In 2026, there are only 10 plans. The deductible went up to $615 and many of the costly prescriptions such as Eliquis, Xarelto, Ozempic, Wegovy, Mounjaro, Rybelsus, Trulicity, Keytruda, and many inhalers. These certainly contributed to the $722 billion that Americans spent on prescription drugs in 2023 (see an overview here: https://www.healthline.com/health-news/top-25-prescription-drugs-spending)

Again, there are safety nets all over Medicare so if you did not look at your plan, or you realized you made a mistake, there mere be ways to fix it in 2026. There are other election periods when you can make plan changes. In fact, the resource I commonly use to see if there is such an election period is one provided to me by one of the largest carriers in the US (but it is 28 pages long). Hopefully you have a trusted partner to help you make decisions. That is the single most helpful thing I recommend to anyone on Medicare; work with an independent insurance broker to help you make your decisions.

Merry Christmas and Happy New Year!