Medicare is not a “set it and forget it” program. Each year, plans, costs, and coverage rules can change—sometimes in small ways, sometimes in ways that significantly impact your healthcare and budget.
As we look ahead to 2026, Lehigh Valley residents should understand what types of Medicare changes may occur, why annual reviews matter, and how working with a local Medicare advisor can help you stay protected and informed.
Why Medicare Changes From Year to Year
Medicare plans are influenced by:
-
Federal regulations
-
Insurance carrier updates
-
Prescription drug cost adjustments
-
Changes to provider networks
Because of this, the plan that worked well for you last year may not be the best fit moving forward.
Medicare Costs May Change in 2026
Premiums, Deductibles, and Copays
Medicare premiums and out-of-pocket costs can change annually. In 2026, beneficiaries may see adjustments to:
-
Medicare Part B premiums
-
Deductibles and copays
-
Prescription drug costs
Even small increases can add up over the course of a year, making it important to understand how your total healthcare spending may be affected.
Income-Related Adjustments
Some beneficiaries may be subject to income-related monthly adjustment amounts (IRMAA). These thresholds and calculations can change, potentially impacting higher-income retirees.
Medicare Advantage Plans Can Change Yearly
Provider Networks and Coverage Areas
Medicare Advantage plans are offered by private insurance companies and can change annually. In 2026, changes may include:
-
Doctors or hospitals leaving a network
-
Adjustments to service areas
-
New referral or authorization requirements
This is especially important for Lehigh Valley residents who want to ensure their preferred doctors and local hospitals remain covered.
Extra Benefits May Be Updated
Many Medicare Advantage plans include additional benefits such as dental, vision, hearing, or wellness services. These benefits are not guaranteed year to year and may change in:
-
Coverage limits
-
Eligibility rules
-
Cost-sharing
Prescription Drug Coverage May Look Different
Changes to Drug Formularies
Prescription drug plans (Part D and Medicare Advantage plans with drug coverage) can change their formularies annually. This means:
-
A medication may move to a different tier
-
Prior authorization rules may change
-
A drug may no longer be covered
Reviewing drug coverage is one of the most important steps heading into 2026.
Pharmacy Network Changes
Your preferred pharmacy may not always remain in-network. Network changes can affect convenience and cost, especially for those managing chronic conditions.
Medicare Supplement Plans and Rate Trends
Rate Adjustments Over Time
While Medicare Supplement (Medigap) benefits are standardized, premiums are not. In 2026, some policyholders may see:
-
Age-related increases
-
Carrier-specific rate adjustments
Reviewing your policy can help ensure you’re still receiving competitive pricing for the coverage you need.
When a Plan Review Makes Sense
Even if you’re happy with your coverage, a periodic review can help identify:
-
Potential savings
-
Better-suited plan options
-
Changes in your healthcare needs
Why Lehigh Valley Residents Should Review Their Medicare Coverage for 2026
Healthcare is personal—and so is Medicare. Local considerations matter, including:
-
Access to Lehigh Valley doctors and hospitals
-
Regional plan availability
-
Local support when questions arise
Working with a local Medicare advisor allows you to receive guidance tailored to your needs, not a one-size-fits-all recommendation.
How a Local Medicare Advisor Can Help
A Medicare advisor can help you:
-
Understand upcoming changes without the confusion
-
Compare plans available in the Lehigh Valley
-
Review costs, coverage, and provider networks
-
Make informed decisions with confidence
Best of all, guidance from a licensed Medicare advisor comes with clarity—not pressure.
Preparing for Medicare in 2026
Medicare changes don’t have to be overwhelming. With the right information and support, Lehigh Valley residents can feel confident heading into 2026 knowing their coverage still meets their healthcare and financial needs.
If you haven’t reviewed your Medicare plan recently, now is a great time to start the conversation and ensure you’re prepared for the year ahead. Schedule an Appointment Today!