Jun 19, 2025

Budget Smarter, Choose Better: How 2026 Medicare Rules Put You in Control

New 2026 Medicare rules aim to improve plan ratings, drug payment options, and give you more control.

Budget Smarter, Choose Better: How 2026 Medicare Rules Put You in Control

Medicare is rolling out new rules in 2026 that could impact both how your plan is rated and how you pay for your prescription drugs. Whether you’re already enrolled in Medicare Advantage or exploring your options for next year, here’s what you need to know to stay ahead.

Smarter Plan Ratings

Starting in 2026, the Centers for Medicare & Medicaid Services (CMS) will introduce updates to how Medicare Advantage (MA) and Part D plans are scored. The goal is to make Star Ratings more accurate and meaningful for beneficiaries like you.

What’s changing:

  • CMS will give more weight to member experience surveys when calculating Star Ratings.
  • Low-performing plans will face new penalties, making quality performance more essential than ever.
  • Plans must be more transparent in their operations and communications.

Why it matters: These changes are designed to help you choose higher-quality plans based on real member feedback, not just administrative data. It also gives you more confidence that your experience will match the marketing.

A New Way to Manage Prescription Costs

Prescription drug affordability is another major focus of the 2026 updates. CMS is fully rolling out the Medicare Prescription Payment Plan, giving Part D enrollees the option to pay out-of-pocket costs in equal monthly installments, rather than all at once.

How it works:

  • You can opt in to spread your total drug costs across the calendar year.
  • Your monthly payment will be fixed, helping you better budget for medications.
  • The program applies to all Part D plans and is available starting in 2026.

Who it helps: This option is especially useful for people with high upfront drug costs early in the year. Instead of facing a large bill in January or February, you can now smooth those expenses across 12 months.

More Protections and Oversight

CMS is also adding guardrails to ensure plans follow these new rules:

  • New reporting requirements for plans to verify how they track and spend member dollars.
  • Updates to how CMS audits and oversees MA and Part D compliance.

These changes aim to strengthen the program's integrity while giving you greater control and clarity.

Bottom Line

The 2026 Medicare rule changes are good news for members looking for transparency, predictability, and quality. With more intuitive plan ratings and smarter drug cost options, the Medicare experience is becoming more user-friendly — and more focused on your needs.

Want to see how these changes might affect your plan or what to consider during the next enrollment season? Read the full CMS announcement here.

Or contact us today. Our licensed advisors are happy to walk you through what’s new and help you prepare for a stronger Medicare experience in 2026.

Our licensed, Michigan-based insurance professionals will help you find and enroll in the best Medicare plan for your unique needs.

Meet with us:

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