Jesse Smedley is the Principal Broker for iHealthBrokers and the founder, president, and CEO of Smedley Insurance Group, Inc. and iHealthBrokers.com. Since the inception of SIG in 2007, Jesse has been dedicated to helping people save money on their health insurance by providing them with resources to educate themselves on all their health insurance options, both under age 65 and Medicare beneficiaries. He is featured in many publications as well as writes regularly for expert columns regarding health insurance and Medicare.
The Medicare Annual Enrollment Period is every year from October 15 to December 7. This is the annual opportunity for Medicare beneficiaries (or their caregivers) to review and change their Medicare Advantage (Part C) plans.
Medicare Advantage Basics
Medicare Advantage is also known as Medicare Part C. It is an alternative to Original Medicare (Parts A & B) and must cover everything Original Medicare covers. However, often MA plans will offer additional benefits like dental, vision, hearing, prescription drugs, and more.
Many plans have no additional premium, but “free” Medicare Advantage plans are not truly free. Beneficiaries must still pay their Part B premium. The government pays private carriers to take on beneficiaries’ financial risk. Carriers use these funds to offer extra benefits.
Pros and Cons of Medicare Advantage
There are pros and cons to choosing a Medicare Advantage Plan. They certainly offer lower upfront costs, especially when compared to Medigap. And with these lower costs, they often offer additional benefits (vision, dental, fitness, etc.).
However, there are network restrictions (HMO or PPO) to take into consideration. Original Medicare has no network limitations. PPOs offer more flexibility, but still not as much as Original Medicare.
There is also the issue of pre-authorization. Plans must approve treatments even if your doctor recommends them. This can result in delays or denials of care.
2026 Updates
Every year, there are changes, and 2026 is no different. Of course, there are changes for the better and changes for the worse.
More plans are adding perks such as transportation assistance, meals after hospital stays, in-home support services, and telehealth options.
CMS is also implementing stricter transparency and timeliness rules. Plans must handle denials and delays more quickly. This is great news!
Additionally, CMS is introducing stricter out-of-pocket cost regulations aimed at protecting those with frequent medical needs.
However, there are actually fewer plan options overall as some carriers exit markets. For example, Aetna is pulling out of many Medicare Advantage markets. Fewer carriers may affect the overall landscape in years to come.
Comparing Plans
You can use Medicare.gov to preview and select a plan. Make sure to compare plan details such as your premium, deductible, and out-of-pocket maximum (both in and out of network). Make sure to look at different plan types like HMOs and PPOs, as well as the benefits they offer, such as vision, dental, hearing, fitness, telehealth, etc. Although these fringe benefits are nice, make sure to make your decision based on core medical needs.
You should also add your prescription drugs to compare total costs and include local and mail-order pharmacies for the best price comparisons.
