By: Chip Hunt
If you or a loved one are enrolled in Medicare, the 2026 open enrollment season may be one of the most challenging in recent memory. A recent Wall Street Journal article titled “Big Changes Are Coming for 2026 Medicare Plans. What You Need to Know” outlines sweeping changes that could affect millions of seniors—including higher premiums, fewer plan options, and reduced benefits.
I’m not a Medicare expert, but I’ve recently had to navigate this maze myself. When Wells Fargo discontinued its retiree health insurance program, I found myself scrambling to help my elderly parents find new coverage. What I thought would be a straightforward process quickly turned into a frustrating and time-consuming ordeal. That experience, along with the WSJ article, compelled me to share what I’ve learned to help others prepare.
Key Takeaways from the WSJ Article
Here are some of the most important points from the article:
- Higher Out-of-Pocket Costs: Many Medicare Advantage plans are raising their annual out-of-pocket maximums. Some are also increasing daily hospital fees and monthly premiums. For example, one plan cited in the article raised its hospital stay fee from $395 to $550 per day and added a $48 monthly premium where there was none before.
- Shrinking Plan Options: Over 1.2 million enrollees may lose their current plans in 2026 due to plan eliminations. Insurers are shifting away from PPOs (which offer more flexibility) toward HMOs, which often require referrals and limit provider networks.
- Fewer Drug Plans: The number of stand-alone Part D drug plans is dropping again—from 464 to 360. Many plans are also switching from flat copays to coinsurance, meaning you’ll pay a percentage of the drug’s cost rather than a fixed amount.
- Reduced Perks: Extras like grocery stipends, gym memberships, and over-the-counter allowances are being scaled back or eliminated altogether.
- Broker Incentives Are Changing: Some plans are cutting commissions to brokers, which may mean fewer agents are incentivized to show you all your options—especially the less profitable ones for them.
What You Can Do Now
If you’re helping a parent or loved one—or reviewing your own coverage—here are a few steps I’d recommend based on both the article and my own experience:
- Start Early: Don’t wait until the last week of open enrollment. Plans are changing fast, and the sooner you start comparing, the better.
- Use Medicare.gov: The Medicare Plan Finder is a powerful tool that lets you compare plans based on your prescriptions, preferred doctors, and more.
- Check Provider Networks: Don’t assume your doctor or hospital is still in-network. Call them directly to confirm—they may not be listed accurately in insurer directories.
- Review the Fine Print: Look at the Annual Notice of Change for your current plan, and dig into the “Summary of Benefits” and “Evidence of Coverage” for any new plans you’re considering.
- Seek Unbiased Help: The State Health Insurance Assistance Program (SHIP) offers free, unbiased counseling in every state. The Medicare Rights Center also has a national helpline.
A Personal Note
Trying to find the right plan for my parents has been overwhelming. Between deciphering plan documents, checking drug formularies, and confirming provider access, it felt like a full-time job. And I work in finance—so I can only imagine how daunting this must be for others.
If there’s one thing I’ve learned, it’s this: the system isn’t designed to be easy. Many of the “helpful” customer service representatives are in reality no help at all. With preparation, persistence, and the right resources, you can make informed decisions. Most of all, patience will protect both your health and your wallet. But prepare yourself for higher overall costs and start planning early.
