Key Dates for 2026

• Changes made during this period take effect January 1, 2026
• This is your annual opportunity to review and modify your Medicare coverage
• Missing this deadline means waiting until next year to make changes

Major Changes for 2026

Medicare Part D Prescription Drug Updates

• Out-of-pocket cap changed to $2,100 (up from $2,000 in 2025)
• Enhanced prescription payment plan options
• Continued $0 copays for most vaccines
• Insulin copay cap remains at $35 per month
• No cost sharing for enrollees in the catastrophic phase

Medicare Advantage Plan Updates

• Government payments to Medicare Advantage plans increase by 5.06% from 2025 to 2026
• Enhanced benefits and coverage options
• Updated provider networks – check if your doctors remain in-network

Premium and Cost Changes

• Medicare Part B premiums expected to increase with inflation adjustments
• Part D premiums may vary by plan
• Deductible amounts will be updated for inflation

What You Can Do During Open Enrollment

• Switch Medicare Advantage Plans: Change to a different Medicare Advantage plan or return to Original Medicare
• Add or Drop Part D Coverage: Enroll in, switch, or drop prescription drug coverage
• Change Medigap Plans: In some cases, you may be able to change your supplemental insurance
• Review Your Current Plan: Even if staying with the same plan, review the 2026 changes

Special Considerations for Brevard County Residents

Local Provider Networks

• Verify that your doctors and specialists remain in your plan’s network for 2026
• Check if your preferred hospitals (like Health First, Steward Health Care) are covered
• Confirm your pharmacy is still in-network

Hurricane Season Preparedness

• Consider plans with out-of-area coverage for emergencies
• Review prescription refill policies for disaster preparedness
• Ensure your plan covers telehealth services

Questions to Ask When Reviewing Your 2026 Options

1. Network Status: Are my doctors, specialists, and hospitals still in-network?
2. Prescription Coverage: Are my medications covered with the same copays?
3. Out-of-Pocket Costs: What’s my maximum out-of-pocket limit for 2026?
4. New Benefits: What additional benefits are offered (dental, vision, wellness programs)?
5. Premium Changes: How much will my monthly premium be in 2026?

When Should You Make Changes?

• Your current plan is being discontinued
• Your medications are no longer covered, or copays have increased significantly
• Your doctors are leaving the plan’s network
• Your premium or out-of-pocket costs increased substantially
• You’re moving or spending extended time outside your plan’s service area

Medicare Advantage vs. Original Medicare for 2026

Medicare Advantage Benefits:

• Often includes prescription drug coverage
• May offer extra benefits like dental, vision, or wellness programs
• Typically lower monthly premiums
• All-in-one convenience

Medicare Advantage Considerations:

• Network restrictions for doctors and hospitals
• May require referrals for specialists
• Coverage may be limited outside your service area

Original Medicare Benefits:

• Freedom to see any doctor who accepts Medicare
• No network restrictions
• Consistent coverage nationwide
• Can add Medigap and Part D separately

Get Help with Your 2026 Medicare Decisions

• Email: info@goldshieldtax.com
• Facebook: www.facebook.com/goldshieldtax
• Instagram: www.instagram.com/goldshieldtax
• Schedule a consultation: https://scheduler.zoom.us/goldshieldtax

Take Action Before December 7, 2025

1. Review your current plan’s 2026 changes – Look for the Annual Notice of Change
2. List your medications – Ensure they’re covered under any new plan
3. Identify your preferred providers – Confirm they’re in-network
4. Compare plans – Use Medicare.gov’s plan finder or get professional help
5. Schedule a consultation – Get personalized advice before the deadline