As the Annual Enrollment Period (AEP) for 2026 approaches, now’s the time to review your Medicare coverage. With major changes ahead, including premium hikes, cost-sharing updates, and a new pilot called the WISeR model, working with a licensed advisor is key to avoiding surprises.
What’s Changing This Coming Year
- Medicare Part B Premium & Deductible Increase
Projected to rise, Part B has historically increased from 5.5% to 11.6% jumps. The Part B annual deductible is also expected to increase about 5%.
- Medicare Part D Premiums, Deductible, and Out-of-Pocket Cap
Part D costs are expecting to increase:
- Base premium
- Deductibles
- Out-of-pocket maximum increasing above $2,000
Starting January 1, 2026, CMS will launch the WISeR (Wasteful and Inappropriate Service Reduction) pilot, focused on reducing medically unnecessary services through enhanced prior authorization in select states and for specific outpatient services. While it won’t change coverage or provider choice under Original Medicare, it may affect approval timelines.
- IRMAA Adjustments and Income Surcharges
Higher-income beneficiaries may face increased surcharges under IRMAA for both Part B and Part D. To see if you will be affected by IRMAA and
- Medigap (Supplemental Plan) Premium Price Shock
What These Changes Mean for You
- Cost increases may significantly reduce your monthly budget, especially if you’re on a fixed income.
- Part D changes may limit available plans or increase premiums, driving enrollment shifts toward Medicare Advantage.
- WISeR may introduce approval delays or administrative burdens for outpatient services.
- Higher income could mean heavier IRMAA surcharges, making proper income planning more important than ever.
Failure to adjust your coverage could lead to overpaying or losing benefits.
Why You Should Schedule an Appointment with Us Before AEP
- Plan for rising costs strategically
- Work with real people, no robo interactions
- We are not a call center, get a personable experience
- We represent most major carriers in your area
- Prevent surprises during AEP
Example Appointment Outcomes
Scenario | What We’ll Do Together |
You currently have Original Medicare + Medigap + PDP | Determine total cost impact, alternatives if needed |
You have high prescription drug costs | Identify optimal Part D plan under updated deductibles and caps |
You expect pre-approvals for outpatient services | Discuss WISeR readiness with providers and preempt delays |
You face IRMAA surcharges | Strategize income adjustments to reduce financial burden |
Take Action Now
AEP runs from October 15 to December 7, but your planning should start now. Waiting risks locking you into a plan that no longer fits your financial or healthcare needs.
Call us today at (512) 687-1476 to arrange a free, no-obligation appointment with one of our licensed Medicare specialists.
Or schedule online here to lock in your preferred time.
Let’s ensure you’re fully prepared, covered and confident in 2026.