If you're getting a new Medicare Advantage plan in 2026, you're probably not alone. Many seniors switch their Medicare coverage each year for a number of reasons.
First, it may be that your former Medicare Advantage plan was discontinued. Or it may be that your former plan changed in a way that made it less desirable (for example, your costs went up), thereby prompting you to get a new one during fall open enrollment.
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There can be a bit of an adjustment period when you're starting out with a new Medicare Advantage plan. Here are a few things to be on the lookout for.
1. Different out-of-pocket costs than what you're used to
Medicare costs for Parts A and B tend to be pretty uniform. With Part A, there's a standard monthly inpatient deductible each time you're admitted to the hospital, and a standard daily coinsurance rate for skilled nursing care. With Part B, there's typically a standard coinsurance rate for different services.
But because each Medicare Advantage plan is unique, the costs you face as an enrollee can vary, depending on the coverage you have. That's why it's important to familiarize yourself with those costs early on in the new year.
Many retirees have a limited income that's a mix of Social Security and modest savings. So it's important to understand what costs you may be looking at.
Read through your plan's details carefully so you understand what copays and deductibles you're required to meet. And also, look at your Medicare Advantage plan's maximum out-of-pocket limit.
One nice thing about Medicare Advantage plans, as opposed to original Medicare, is that they cap your out-of-pocket spending. That's a good thing, as it could help you better manage your retirement income and savings. But if you anticipate needing a lot of medical care in 2026, it's important to know what your plan's limit entails.
2. A new provider network
One big difference between original Medicare and Medicare Advantage is that with the latter, you're typically limited to a specific network of providers. And going outside of that network could mean having to spend a small fortune on your care.
It's important to see which doctors of yours are in your plan's network. If any key specialists of yours aren't in-network, take the time to line up new ones before you're due for appointments so you don't have to scramble or delay necessary care.
It's also crucial to see which pharmacies are in-network under your plan. You don't want to end up paying more for medications by choosing the wrong place to fill your prescriptions.
3. Telehealth options to make your care more accessible
Many Medicare Advantage plans continue to expand their telehealth options. If you have mobility challenges or live in a more remote part of the country, it's important to see what telehealth services your plan offers.
These may include virtual visits with your primary doctor or virtual monitoring for different health conditions you may have. Mental health services may also be available to you virtually.
Keep in mind that depending on your plan, accessing care remotely could mean lower costs. In some cases, your copays may even be waived. But again, you need to check your plan's specific rules and benefits to know what to expect.
It's important to fully understand what costs, rules, and benefits you're subject to when you begin your coverage with a new Medicare Advantage plan. Be sure to familiarize yourself with the items above so you can make the most of your coverage and, just as importantly, avoid unnecessary costs that make healthcare more expensive for you in the new year.
