Medicare Annual Enrollment Period 2026: What's Actually Different This Year
Every year the advice is basically the same: review your plan, don't assume it renews as-is. This year that advice matters more than usual, and the numbers explain why.
Medicare's Annual Enrollment Period runs October 15 through December 7, 2026. During it, anyone on Medicare can switch Medicare Advantage plans, switch or drop a Part D drug plan, or move between Original Medicare and Medicare Advantage — changes take effect January 1, 2027. What makes this year worth paying closer attention to: plan terminations have roughly doubled, and the two largest Medicare Advantage insurers are both shrinking their service areas. "My plan worked fine last year" is a weaker assumption than usual going into this AEP.
Most AEP advice reads the same every year, and after a while it stops registering — "review your coverage," "compare your options," said in the same tone every October. This year the underlying numbers actually back that advice up more than usual. Insurers are pulling back from Medicare Advantage in a way that hasn't happened at this scale recently, and a meaningful share of current enrollees are going to open their mail this fall and find out their plan isn't being offered in their area next year, whether they were planning to shop around or not.
What AEP actually lets you change
Three things, and only these three: switch from one Medicare Advantage plan to a different one, switch between Original Medicare and Medicare Advantage in either direction, and join, switch, or drop a Part D prescription drug plan. That's the full scope. It doesn't touch your Initial Enrollment Period status if you haven't signed up for Medicare at all yet, and it isn't when you'd buy a Medigap policy for the first time — Medigap has its own separate, mostly one-time guaranteed-issue window tied to when your Part B first started, not to AEP.
Whatever you choose during this window, the effective date is the same regardless of when in the six-and-a-half weeks you make it: January 1, 2027. There's no advantage to acting on October 16 versus December 6 — the only real deadline pressure is the December 7 cutoff itself.
Why this year's AEP carries more weight than usual
Every fall, health policy researchers at KFF (formerly the Kaiser Family Foundation) publish a first look at the coming year's Medicare Advantage plan offerings, and the 2026 numbers are notably worse than 2025's. The average Medicare beneficiary has access to 32 Medicare Advantage prescription drug plans in 2026, down from 34 in 2025 — and counting every plan type, not just MA-PD, the average options dropped from 42 to 39. That's a real, measurable contraction, not a rounding difference.
The two companies driving most of it are the two largest Medicare Advantage insurers in the country. UnitedHealthcare is exiting 225 counties while entering only 14, shrinking its footprint to 80% of U.S. counties, down from 87% in 2025. Humana is exiting 198 counties while entering just 5, dropping from 89% to 82% of counties. Thirty-five states, plus DC and Puerto Rico, saw a net reduction in the number of plans available to their average beneficiary, and 122 counties across 13 states now have zero Medicare Advantage plans offered at all — not fewer options, none.
The statistic that matters most for anyone currently enrolled: roughly 13% of people in an individual Medicare Advantage prescription drug plan this year — about 2.6 million people — are losing that plan for 2026. That's roughly double the prior year's termination rate of about 6%, or 1.3 million people. If your plan is one of them, staying enrolled isn't actually an option; you'll be defaulted into a replacement plan if you don't choose one yourself, and that default isn't guaranteed to be a good fit for your specific prescriptions or doctors.
Average Plan Options
39 total Medicare Advantage plan options per beneficiary in 2026, down from 42 in 2025. MA-PD plans specifically: 32, down from 34.
Insurer Pullback
UnitedHealthcare: exiting 225 counties, now in 80% of U.S. counties (was 87%). Humana: exiting 198 counties, now in 82% (was 89%).
Zero-Option Counties
122 counties across 13 states now have no Medicare Advantage plan available at all, for 2026.
Plan Terminations
About 13% of MA-PD enrollees (2.6 million people) are losing their current plan for 2026 — double last year's roughly 6% (1.3 million).
The letter you shouldn't set aside: your Annual Notice of Change
If you're in a Medicare Advantage plan or a standalone Part D plan, your insurer is required to mail you an Annual Notice of Change (ANOC) by September 30 — about two weeks before AEP opens, on purpose, so you have time to actually read it before deciding whether to act. The ANOC lists every change to your specific plan for the coming year: premium, deductible, copays, and — this is the part people skip past most often — your drug formulary and provider network. A plan can keep an identical premium and still meaningfully change what it covers or who's in-network. If you only have a Medigap policy, you won't get an ANOC, since Medigap benefits are standardized by law and don't change year to year.
The practical habit worth building: when the ANOC arrives, check your actual medications against the plan's formulary for next year, not just the premium line. Drug formularies shift more than people expect — insurers have been trimming the number of drugs listed and changing which tier a given drug falls into, which can turn a $10 copay into a much larger one without your premium changing at all.
What Medicare itself costs in 2026, as background
Separate from plan-specific changes, a few federal numbers shifted for 2026 that are worth having in mind while you compare options. The standard Part B premium is $202.90/month, up from $185.00 in 2025. On the Part D side, the standard deductible can run up to $615, but the number that matters more is the annual out-of-pocket cap: $2,100 for 2026, up slightly from $2,000 in 2025 — once your covered drug costs hit that number for the year, you pay $0 for the rest of it. If you're in a Medicare Advantage plan, the federal ceiling on in-network out-of-pocket costs is actually lower this year, $9,250 versus $9,350 in 2025, though individual plans can and do set their own limit below that. Insulin stays capped at $35/month across Part D plans, unchanged. And if your income is high enough to trigger IRMAA, the surcharge tiers start at $109,000 for single filers and $218,000 for joint filers, based on your 2024 tax return. This site's Medicare Cost Calculator and IRMAA Calculator turn these into your specific monthly number.
AEP versus the other Medicare enrollment windows
AEP gets confused with a couple of other windows constantly, so it's worth being precise. The Medicare Advantage Open Enrollment Period runs January 1 through March 31 — narrower on two counts, since it's only available if you're already in a Medicare Advantage plan, and it allows just one additional switch (to a different MA plan, or back to Original Medicare), not the full menu AEP offers. If you're new to Medicare entirely, your Initial Enrollment Period is the seven-month window around your 65th birthday, unrelated to AEP timing. And a Special Enrollment Period can open outside all of these if you have a qualifying life event — moving, losing employer coverage, a plan leaving your area entirely (which, given this year's insurer pullback, is a real possibility for more people than usual). This site's Medicare Enrollment Period Finder sorts out which window actually applies to your situation, and the AEP Countdown tracks exactly how many days are left in the current window.
How to actually compare plans, not just skim them
The official Medicare Plan Finder at medicare.gov is still the most complete tool for a real side-by-side, since it pulls current formulary and network data directly rather than relying on a plan's own marketing summary. The comparison worth doing properly has three parts, in order of how often people skip them: first, enter your actual medications and dosages, not a general drug category, since formulary tier placement is specific down to the exact drug; second, if you have a Medicare Advantage plan, confirm your specific doctors and any hospital you'd realistically use are still in-network for next year, not just this year; third, and only after those two, compare the premium and out-of-pocket structure. Premium is the easiest number to compare and the least likely to be the thing that actually costs you money over a full year of care.
If you'd rather not do this alone
None of this requires figuring it out solo. SHIP (State Health Insurance Assistance Program) counselors offer free, one-on-one Medicare help, and unlike an insurance agent, they don't sell any product or earn a commission on what you choose — they're funded specifically to be neutral. Given the plan volatility this AEP, a session with a SHIP counselor is a reasonable use of an hour even for people who've handled their own Medicare decisions in past years without issue. This site's SHIP Counselor Locator connects you to your state's program.
Frequently Asked Questions
When is the Medicare Annual Enrollment Period in 2026?
October 15 through December 7, 2026. Any change you make takes effect January 1, 2027, regardless of which day during that window you make it.
What can I actually change during AEP?
Switch from one Medicare Advantage plan to another, switch between Original Medicare and Medicare Advantage in either direction, and join, switch, or drop a Part D prescription drug plan.
Why does AEP matter more this year?
Plan terminations have roughly doubled for 2026 — about 13% of Medicare Advantage prescription drug plan enrollees, an estimated 2.6 million people, are losing their current plan, up from 6% the year before. UnitedHealthcare and Humana, the two largest Medicare Advantage insurers, are both exiting more counties than they're entering.
What is the Annual Notice of Change (ANOC)?
A letter your Medicare Advantage or Part D plan is required to send by September 30 each year, listing every change to your plan for the coming year — premium, deductible, copays, drug formulary, and provider network. If you only have Medigap, you won't receive one, since Medigap benefits don't change annually.
Is AEP the same as the Medicare Advantage Open Enrollment Period?
No. AEP (Oct 15–Dec 7) is open to anyone on Medicare and allows the full range of changes. The Medicare Advantage Open Enrollment Period (Jan 1–Mar 31) is only for people already in a Medicare Advantage plan, and allows just one additional switch.
This article is for general educational purposes and reflects federal Medicare figures and market-wide plan data as of August 2026. It is not insurance, financial, or medical advice, and it doesn't reflect the terms of any specific plan. For your exact plan options and deadlines, check your Annual Notice of Change, medicare.gov, or your state's SHIP program.