Since 1965, Medicare has been the U.S. federal health insurance program helping to lower healthcare costs for seniors. To qualify, you must be at least 65 years old or have certain disabilities.
Unfortunately, Medicare isn't the easiest program to understand, largely due to all its moving parts. This year is no different, with three major changes kicking in to start 2026. If you're a retiree or will be soon, here's what you need to know about them.
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1. Medicare is becoming more expensive
Inflation impacts many different products and services, including Medicare. Beginning in 2026, standard Medicare Part B premiums are increasing to $202.90 per month, up from $185 in 2025. This $17.90 jump is the largest year-to-year jump since 2022.
With most people paying this cost from their Social Security benefits, it could offset the benefits bump from the 2.8% cost-of-living adjustment (COLA).
2. New prior-authorization requirements
On Jan. 1, Medicare began rolling out a pilot program that requires people to get prior authorization for certain medical procedures and devices that the government may deem "wasteful." Example procedures include knee surgery for arthritis, skin grafts, and knee stimulators.
The program, called Wasteful and Inappropriate Service Reduction (WISeR), will run for six years across six test states: Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington.
The Centers for Medicare & Medicaid Services has framed this program as a way to save taxpayer money on wasteful healthcare spending. It says the items and services selected "have been a source of fraud, waste, abuse, and inappropriate utilization."
3. Coverage for telehealth services is becoming more restrictive
The COVID-19 pandemic opened the door to greater telehealth flexibility with Medicare, but now the program is becoming more restrictive again. Beginning on Jan. 31, Medicare beneficiaries must be in a physical medical facility and in a rural area to have telehealth services covered. A few exceptions to this change would include services such as behavioral health, kidney disease care, and stroke evaluations.
This change could cause more inconvenience to people who were used to handling certain doctor visits over video calls. They now have to spend time and money (such as transportation costs) to get the same things accomplished.
