Medicare looks a little different in 2026. Costs went up modestly, the yearly cap on prescription drug spending rose to $2,100, the first ten negotiated drug prices took effect, and a few new programs launched, including a $50-a-month option for certain weight-loss medications. Most of this asks nothing of you right now: the changes apply automatically, and the decisions that matter come during open enrollment this fall. Here is what actually changed, in plain English. (Full disclosure: Slothwise, the company behind this site, makes one of the apps listed in the Medicare App Library on Medicare.gov, which comes up below.)

How much does Medicare cost in 2026?

The standard Part B premium is $202.90 per month in 2026, up $17.90 from $185 in 2025. The Part B annual deductible is $283, up from $257. For hospital stays, the Part A deductible is $1,736 per benefit period, up from $1,676. CMS notes the Part B increase would have been about $11 per month higher if not for a big payment fix on one category of medical supplies.

Higher-income beneficiaries pay an extra amount called IRMAA. For 2026 it starts above $109,000 of income for an individual or $218,000 for a couple, based on your 2024 tax return. About 8 percent of people with Medicare pay it; everyone else pays the standard premium.

What is the prescription drug cap for 2026?

Once your out-of-pocket spending on covered Part D drugs reaches $2,100 in 2026, you pay nothing more for covered drugs the rest of the year. The cap was $2,000 in 2025 and adjusts a little each year, which is worth knowing because many websites still show the old number. The highest deductible a drug plan can charge in 2026 is $615. Insulin is still capped at $35 a month, and recommended adult vaccines are still free.

If you use the Medicare Prescription Payment Plan, which spreads drug costs into monthly installments instead of big pharmacy bills, one 2026 change helps: if you were enrolled in 2025, your enrollment renews automatically unless you opt out. It is still free, with no interest, and it does not lower your total cost; it just smooths it out.

Which drugs have negotiated prices now?

On January 1, 2026, Medicare's first negotiated prices took effect for ten widely used drugs: Eliquis, Xarelto, Jardiance, Farxiga, Januvia, NovoLog, Entresto, Enbrel, Stelara, and Imbruvica. The negotiated prices are substantially below the old list prices. For a 30-day supply, Eliquis is now $231 against a 2023 list price of $521, Jardiance is $197 against $573, and Januvia is $113 against $527.

One important thing to understand: the negotiated price is a ceiling on what your drug plan pays the manufacturer, not a promise about your copay. What you pay at the pharmacy still depends on how your plan tiers the drug, and some plans changed cost-sharing this year. If your copay on one of these drugs looks wrong, check how your plan covers it rather than assuming the negotiated price failed. A second round covering 15 more drugs, including Ozempic and Wegovy, has prices already set that take effect January 1, 2027.

Does Medicare cover Ozempic or Wegovy for weight loss in 2026?

Regular Medicare drug coverage still does not pay for medications used for weight loss itself. That law did not change. GLP-1 drugs remain covered only for approved medical uses, such as type 2 diabetes, or Wegovy for reducing cardiovascular risk in certain patients.

What is new, as of July 1, 2026, is a temporary federal program called the Medicare GLP-1 Bridge. Through the end of 2027, it offers eligible people with Part D a flat $50 per month for certain GLP-1 medications used for weight management: Wegovy, the KwikPen form of Zepbound, and Foundayo. Two things to know before you get your hopes up at the pharmacy counter: Ozempic and Mounjaro are not part of it, and the $50 payments do not count toward your $2,100 drug cap, because the program runs outside your regular drug plan. If you think you might qualify, ask your doctor or call 1-800-MEDICARE.

Is telehealth still covered in 2026?

Yes. After a brief lapse early in the year, Congress extended Medicare telehealth coverage retroactively, and the current rules run through December 31, 2027. You can have telehealth visits from home, audio-only visits count when video is not an option, and physical, occupational, and speech therapists can treat you by telehealth. Mental health telehealth is permanent and does not expire. What happens after 2027 depends on Congress, so enjoy it while it is simple, as of mid-July 2026.

Why does my Medicare Summary Notice only come every six months now?

Starting January 2026, Medicare mails paper Medicare Summary Notices every six months instead of every three, and only for periods when you actually had claims. Nothing is wrong with your mail. If you prefer not to wait, you can switch to electronic notices in your Medicare.gov account and get them monthly. Since each notice now covers more visits, it is worth reading carefully; our guide to reading your Medicare Summary Notice and catching billing errors walks through it line by line.

Does Original Medicare require prior authorization now?

Mostly no, with one narrow new exception. A six-year pilot called WISeR started in January 2026 in six states: New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington. It applies only to a short list of outpatient procedures that Medicare considers frequently overused, such as skin substitutes, certain spine injections, and certain knee procedures. Your doctor's office handles the paperwork, any denial has to come from a licensed clinician rather than a computer alone, emergency and hospital-stay care are excluded, and your appeal rights do not change. If you live outside those six states, or your care is not on that short list, nothing is different for you.

What changed in Medicare Advantage for 2026?

Two changes worth knowing if you have a Medicare Advantage plan. First, plans must now keep their provider directories accurate in Medicare's official Plan Finder, updating them within 30 days of a change, so checking whether your doctor is in a plan's network got more reliable. Second, if you joined a plan relying on directory information that turned out to be wrong, and you discover within three months that your doctor is not actually in network, you get a special window to switch plans. Plans also face new requirements to explain prior authorization denials clearly and publish their statistics.

What is the Medicare App Library?

Medicare.gov added a page in April 2026 called the Medicare App Library: a list of health apps from private companies that passed an independent review of their privacy and security practices, with rules that they can only see the Medicare information you choose to share and can never sell or share your data. Browsing is free and using any of it is optional. We wrote a full plain-English guide to what the Medicare App Library is and how to use it safely.

What are the Extra Help limits for 2026?

Extra Help, the program that lowers Part D drug costs for people with limited income, has 2026 income limits of $23,475 a year for an individual and $31,725 for a married couple living together, with resource limits of $18,090 and $36,100. If you qualify, brand-name drugs cost at most $12.65 and generics at most $5.10, and you can switch drug plans once a month instead of waiting for open enrollment. If your income is anywhere near these numbers, it costs nothing to apply through Social Security.

What should you check during open enrollment this fall?

Open enrollment for 2027 runs October 15 through December 7, 2026, and changes take effect January 1, 2027. Your plan must mail its Annual Notice of Change by September 30. Given what changed this year, four checks matter most:

1. Your drug costs, not just the headlines. If you take a negotiated-price drug, look up your actual copay for 2027 in Medicare Plan Finder, because plans set tiers differently.

2. Your plan's premium and its very existence. Standalone drug plan premiums moved around this year; the Annual Notice of Change tells you if yours is rising or ending.

3. Your doctors. Plan Finder now shows Medicare Advantage networks with new accuracy rules; confirm your doctors and hospital before switching.

4. Your specific drugs. Formularies shift as plans adjust to the spending cap; make sure everything you take is still covered.

If you like your plan and the Annual Notice of Change shows nothing alarming, doing nothing is a legitimate choice; your plan renews automatically.

Common questions

Do I need to do anything right now? Probably not. The 2026 changes applied automatically. Your one job this year is reading the Annual Notice of Change that arrives by September 30 and doing the four checks above during open enrollment.

Why is my Eliquis still expensive if Medicare negotiated the price? The negotiated price caps what your plan pays the manufacturer. Your copay depends on your plan's tier for the drug. If it looks high, compare plans during open enrollment with your actual drug list.

Who qualifies for the $50 GLP-1 Bridge? People with Part D coverage using one of the included drugs for weight management: Wegovy, Zepbound in its KwikPen form, or Foundayo. It runs through December 31, 2027. Ask your doctor whether it fits your situation, or call 1-800-MEDICARE.

Is there a new Medicare card in 2026? No. Your current card stays valid. Anyone who calls saying you need a new card, or that you must pay or verify anything to keep your card, is running a scam. Hang up.

How can Slothwise help?

A year like this is exactly when keeping track gets hard: new costs, new notices arriving half as often, and drug prices that changed for reasons nobody explains at the pharmacy counter. Slothwise brings your health information together in one place, explains your Medicare paperwork in plain English, and answers questions about your specific situation, like what a notice means or why a charge looks off. You can use it in the app or right from your text messages, and it is free to start, with no credit card.

Slothwise is one option, not the only one. Everything in this article can be handled through Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Assistance Program (SHIP), which offers free one-on-one counseling, especially during open enrollment.

The short version

• Part B costs $202.90 a month in 2026 with a $283 deductible; the Part A hospital deductible is $1,736.

• The Part D drug cap is $2,100 for the year (not $2,000, which was 2025). Insulin stays $35 a month; recommended vaccines stay free.

• Ten drugs got negotiated prices in January, but your copay depends on your plan's tier, so check yours.

• The new GLP-1 Bridge offers Wegovy, Zepbound (KwikPen), or Foundayo at $50 a month for weight management through 2027. Ozempic and Mounjaro are not included.

• Telehealth from home is covered through December 31, 2027; mental health telehealth is permanent.

• Open enrollment is October 15 to December 7. Read your Annual Notice of Change, then check your drugs, costs, and doctors in Medicare Plan Finder.

Slothwise is not affiliated with or endorsed by Medicare, the Centers for Medicare & Medicaid Services, or any government agency, and does not sell, endorse, or recommend any Medicare plan. This article is general information, not legal, financial, or medical advice. For questions about your specific coverage, contact 1-800-MEDICARE, your State Health Insurance Assistance Program (SHIP), or a qualified professional. Last updated: July 2026.