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Benzinga
Benzinga
Vandana Singh

Medicare Beneficiaries To See Slight Premium Decline Next Year

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The Centers for Medicare & Medicaid Services (CMS) announced on Friday that Medicare Advantage (MA) and Medicare Part D prescription drug program premiums, benefits and plan options are expected to remain largely stable in 2026.

Average premiums are projected to decline slightly, reinforcing CMS’s commitment to providing beneficiaries access to affordable, high-quality health care while protecting taxpayer dollars.

CNBC cited CMS’s critical services for Medicare and Medicaid would not be affected by a shutdown, though the agency would not have funding to provide oversight to contractors, including those who administer the Medicare call centers.

CMS Administrator Dr. Mehmet Oz highlighted, “CMS anticipates that enrollment in MA in 2026 will be more robust than the plans' projections and that enrollment will be stable."

Also Read: Home Health Braces For Potential $1 Billion Cut In Medicare Payments

Medicare Advantage

CMS estimates the average monthly premium for all MA plans, including MA Special Needs Plans (SNPs) and plans with prescription drug coverage, will drop from $16.40 in 2025 to $14 in 2026.

Supplemental benefits such as dental, vision and hearing are expected to remain unchanged.

While MA enrollment is projected by plans to fall slightly from 34.9 million in 2025 to 34 million in 2026, CMS anticipates enrollment will likely be more stable, following recent trends.

Access to MA plans remains robust, with more than 99% of Medicare beneficiaries able to choose a plan, and 97% having access to 10 or more plan options. Nationally, the total number of MA plans will see a minor decline from 5,633 to roughly 5,600.

Medicare Part D

The average total premium for standalone Part D plans is projected to fall from $38.31 in 2025 to $34.50 in 2026. For MA plans with drug coverage, the average total Part D premium after rebates is expected to decrease from $13.32 to $11.50.

Open Enrollment Resources

CMS has added new tools this year, including AI-powered prescription cost estimators, enhanced filtering for supplemental benefits and options to check whether plans accept existing healthcare providers.

Medicare Open Enrollment will run from Oct. 15, 2025, to Dec. 7, 2025.

Reuters noted that budget standoffs are common in Washington, usually resolved at the last minute. This time, uncertainty is heightened as President Donald Trump refuses to spend the billions approved by Congress and threatens further federal workforce cuts if a shutdown occurs. So far, only a few agencies have outlined their contingency plans.

The debate centers on $1.7 trillion in discretionary spending, covering agency operations — about a quarter of the $7 trillion federal budget. The remainder largely funds health, retirement programs and interest on the $37.5 trillion debt.

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Photo: Shutterstock

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