Medicare Annual Enrollment Period (October 15 – December 7): Do You Need Assistance?
Medicare’s 2026 Annual Enrollment Period kicked off on October 15 and concludes December 7, 2026.
Compare plans annually
Do not assume last year’s Medicare Advantage or Part D plan is still the best. Formularies, networks, and premiums change, and shopping around can save you real money. In 2027, Medicare beneficiaries will face significant changes, including the expiration of temporary Part D premium stabilization subsidies, an increase in the Part D out-of-pocket spending cap to $2,400, and lower negotiated prices for 15 major prescription drugs under the Inflation Reduction Act.
Major Program and Policy Changes
End of Part D Premium Subsidies: The temporary federal relief program that lowered monthly Part D premiums over the past two years is expiring at the end of 2026, which is expected to cause standard market premiums to rise.
New Negotiated Drug Prices: Starting January 1, 2027, lower federally negotiated prices take effect for 15 additional high-cost Part D drugs—including popular GLP-1 medications (Ozempic, Wegovy, Rybelsus), respiratory treatments (Trelegy Ellipta), and cancer therapies (Xtandi, Ibrance).
Medicare Advantage Market Shifts: Major private insurers are scaling back plan availability, tightening provider networks, or exiting specific county markets, impacting over 1 million enrollees who may find their plans terminated or significantly altered.
Electronic Prior Authorizations: Medicare Advantage plans must implement electronic prior authorization systems starting January 1, 2027, to streamline utilization management and speed up coverage decisions.
Telehealth Extension: Expanded Medicare telehealth flexibilities—allowing beneficiaries to receive virtual care from home anywhere in the U.S.—have been extended through December 31, 2027.
Use your HSA
If you have a Health Savings Account, withdrawals for Medicare premiums and qualified medical expenses are tax-free.
Keep income in check
Medicare premiums are based on your taxable income. Using strategies like Qualified Charitable Distributions (QCDs) from IRAs can satisfy RMDs without raising your Adjusted Gross Income (AGI).
Revisit Roth conversions
Spreading smaller conversions over several years can help reduce future RMDs and keep you below higher Medicare premium brackets.
Give strategically
Bunching charitable gifts or funding a donor-advised fund can lower taxable income in high-income years.
If you would like to review your current plan to confirm it still meets your health care needs and budget, please let us know. River Wealth Advisors has partnered with two brokerage companies to help you with your Medicare and insurance needs:
URL Insurance Group: we would be happy to introduce you to one of our dedicated URL team members
Keystone Insurance Strategies & Solutions: Stewart Brouse, President
Phone:717.215.6066
River Wealth Advisors, LLC, URL Insurance Group and Keystone Insurance Strategies & Solutions are unaffiliated entities. River Wealth Advisors receives no compensation of any kind from URL Insurance Group or Keystone Insurance Strategies & Solutions. River Wealth Advisors is not an insurance agency and does not provide Medicare enrollment services. Clients are under no obligation to engage URL Insurance Group or Keystone Insurance Strategies & Solutions for services.