Proposed Medicare Advantage Changes 2027
The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule for the 2027 contract year that could reshape Medicare Advantage (MA) and Part D prescription drug coverage. The agency aims to “strengthen quality, improve access, and modernize benefits” while reducing administrative burdens on plans.
Here’s what beneficiaries, providers, and policymakers need to know.
Star Ratings Overhaul
CMS proposes removing 12 Star Rating measures that are largely administrative or show little variation between plans. The focus will shift to meaningful metrics, including clinical outcomes, preventive care, and patient experience.
- New focus on outcomes: Plans will be evaluated more on health results than paperwork.
- Mental health measure: CMS plans to introduce a “Depression Screening and Follow-Up” measure for future cycles.
- Health equity bonuses paused: The previously planned “Excellent Health Outcomes for All” bonus is postponed, though CMS invites feedback on equity initiatives.
Impact: Beneficiaries may find it easier to identify high-quality plans, while insurers may redirect resources toward improving actual care.
Enrollment Flexibility
The proposed rule adds a new Special Enrollment Period (SEP) for beneficiaries whose providers leave a plan’s network. This allows mid-year plan changes without waiting for the regular enrollment window. CMS also codifies other existing SEP policies, making the system more consistent.
Impact: This change ensures continuity of care for people with chronic conditions or preferred providers.
Watch a video on the discontinued Medicare advantage plan special enrollment period
Part D and Drug Coverage Updates
The rule formalizes Part D reforms started under prior legislation, including:
- Eliminating the coverage gap (donut hole) phase.
- Maintaining reduced out-of-pocket thresholds.
- Removing cost-sharing in the catastrophic phase.
- Adjusting how True Out-of-Pocket (TrOOP) costs are calculated.
Impact: Beneficiaries gain more predictable and affordable prescription drug coverage.
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Reducing Administrative Burden
CMS proposes measures to reduce paperwork and regulatory complexity, such as:
- Exempting certain account-based plans from creditable coverage disclosures.
- Lifting requirements for mid-year notices about unused supplemental benefits.
- Removing some health-equity reporting mandates for plans.
Impact: Plans may operate more efficiently, but some transparency and oversight could be reduced.
Why It Matters
- Patient-focused quality: More emphasis on outcomes and experience could improve care.
- Drug cost protection: Part D reforms continue to protect beneficiaries from high out-of-pocket expenses.
- Flexible enrollment: The new SEP enhances access to care when providers leave networks.
- Efficiency vs. oversight: Streamlined administration may improve plan operations but reduce some accountability.
- Future reform: CMS is constantly making changes to improve MA plans, and stakeholders have the chance to provide input.
CMS’s 2027 proposed rule could bring meaningful improvements for beneficiaries while easing administrative burdens for insurers. The Star Ratings overhaul, enrollment flexibility, and Part D updates are poised to enhance care and reduce costs. However, reduced oversight and postponed equity initiatives highlight areas to watch as the public-comment process unfolds.
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What to Know About Medicare Deductibles in 2026
Each year, Medicare updates its premiums, coinsurance, and deductibles. Understanding Medicare deductibles for 2026 is very important for beneficiaries. There are some important changes; especially for Medicare Part A and Medicare Part B.
Medicare Part A (Hospital Insurance)
Part A helps cover inpatient hospital stays, skilled nursing facility care, hospice, and some home-health services. In 2026, the inpatient hospital deductible for Part A is $1,736 per benefit period.
A “benefit period” begins at admission to the hospital and ends when you’ve been out of inpatient care (hospital or skilled nursing) for 60 consecutive days. That means every time a new benefit period starts, the deductible resets.
If your hospital stay extends past 60 days, daily coinsurance for days 61–90 (and beyond) will apply. These additional costs can add up underscoring why understanding the deductible is important for budgeting.
Medicare Part B (Medical Insurance)
Part B covers doctor visits, outpatient services, durable medical equipment, and more. For 2026:
- The standard monthly premium is $202.90.
- The annual deductible is $283.00.
You only pay the Part B deductible once per calendar year (if you receive Part B-covered services). After that, Medicare generally covers 80% of approved costs; you pay the remaining 20% (assuming your provider accepts Medicare assignment).
Learn the differences between Medicare Advantage vs Medicare Supplements
What This Means in Practice
- If you’re admitted to the hospital under Part A in 2026, you’ll need to pay $1,736 before Medicare begins to pay (for up to the first 60 days of a stay).
- If you use outpatient services or see a doctor under Part B, you’ll first need to meet the $283 annual deductible; once met, most services are covered at 80%.
- Because Part A’s deductible applies per benefit period (not per calendar year), multiple hospitalizations in one year could mean paying more than once.
Why You Should Care
Understanding Medicare deductibles is key to predicting out-of-pocket costs. For someone watching their budget, a hospital stay could require a substantial lump sum before coverage kicks in; for routine care under Part B, costs are more manageable, but still meaningful, especially for those on fixed incomes.
These 2026 changes also underscore the importance of evaluating supplemental coverage (like Medigap) or alternative plans to mitigate risk.
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Part B IRMAA Brackets 2026: What You Need to Know
Medicare Part B is a cornerstone of health coverage for many retirees, but for higher-income beneficiaries, there’s an additional cost: the Income-Related Monthly Adjustment Amount, better known as IRMAA. Understanding the Part B IRMAA brackets 2026 and how those adjustments work can help you plan your income, taxes, and healthcare costs.
What Is IRMAA — and Why It Matters
IRMAA is a surcharge added to Medicare Part B (and Part D) premiums for people whose income exceeds certain thresholds. Rather than base your premium solely on your age or election timing, IRMAA considers your Modified Adjusted Gross Income (MAGI) from two years earlier. In other words: your 2024 tax return determines what you pay for Medicare in 2026,
MAGI for Medicare includes your AGI (Adjusted Gross Income) plus certain tax-exempt sources like municipal bond interest.
Because of this “look-back,” proper planning in advance is critical; a one-time income spike (for example, a large capital gain or Roth conversion) in 2024 could significantly increase your 2026 Medicare premiums.
The 2026 IRMAA Brackets for Medicare Part B
Here’s a breakdown of the 2026 IRMAA income brackets (based on 2024 MAGI) and what they mean for your monthly Medicare Part B premium.
| MAGI (2024) | Filing Status | 2026 Part B Premium Estimate |
|---|---|---|
| Up to $109,000 | Single | $202.90 (no surcharge) |
| $109,001 – $137,000 | Single | $284.10 |
| $137,001 – $171,000 | Single | $405.80 |
| $171,001 – $205,000 | Single | $527.50 |
| $205,001 – $499,999 | Single | $649.20 |
| $500,000+ | Single | $689.90 (top IRMAA tier) |
For couples filing jointly, the thresholds roughly double (e.g., up to $218,000 for no surcharge).
Why 2026 Premiums Are Rising
- The base Part B premium is increasing significantly: for 2026, it’s $202.90/month; up from $185 in 2025.
- Surcharges (IRMAA) are also escalating. The top surcharge for Part B is projected around $487/month, putting the total premium at $689.90 for the highest bracket.
- These adjustments are not just about inflation: the IRMAA brackets themselves are being re-indexed, which will pull more people into higher tiers over time.
Putting that in perspective: many beneficiaries on fixed incomes could face a bigger Medicare burden and it’s especially important for those with variable or investment income.
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Strategies to Manage or Reduce IRMAA
Because IRMAA hinges on reported MAGI from two years prior, you may have opportunities now (for your 2024 tax year) to influence your 2026 Medicare costs. Here are some strategies:
- Mind your MAGI
- Prioritize tax-efficient withdrawals in retirement (e.g., Roth conversions, IRA/401(k) distributions) to control your AGI.
- Consider timing of capital gains: if you realize large gains in 2024, you may push yourself into a higher IRMAA bracket.
- Use strategic charitable giving
- Qualified Charitable Distributions (QCDs) from your IRA can lower your taxable income without affecting your MAGI in the same way as other income sources.
- File an SSA-44 (Life-Changing Event)
- If your income drops significantly (due to retirement, unemployment, or other life events), you can file a Form SSA-44 to request a re-determination of IRMAA.
- But note: you need documentation, like proof of reduced income, to support your case when submitting.
- Plan ahead for Medicare Advantage vs Medigap
- Higher IRMAA could make certain Medigap (supplement) plans less attractive; it may also influence whether Part D surcharges make a zero-premium Medicare Advantage plan more favorable.
Things to Consider
- Your 2024 income matters – a lot. What you earned (or didn’t) in 2024 directly impacts your 2026 Medicare Part B costs.
- IRMAA is rising. Even modest increases in MAGI could push you into a higher surcharge bracket.
- You have agency. With smart tax planning and proactive strategies, you may be able to mitigate how much IRMAA you pay, but timing and strategy matter.
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Stand-Alone Dental Plans – Why Medicare Agents Should Offer Them
Stand-alone dental coverage has become one of the most valuable add-ons for Medicare beneficiaries and a smart cross-sell opportunity for agents. Because Original Medicare does not cover routine dental care, seniors face steep out-of-pocket costs for services they use frequently. Offering stand alone dental plans fills this gap and strengthens your overall product portfolio.
Medicare Leaves a Major Dental Gap
Original Medicare excludes cleanings, exams, fillings, crowns, dentures, implants, and more. Beneficiaries often don’t realize this until they get the bill. Dental plans help you address this common pain point and provide solutions your clients genuinely need.
High Demand Among Seniors
Dental needs increase with age; gum disease, decay, cracked teeth, and periodontal issues. Stand-alone plans offer predictable costs and access to affordable care, making them an easy sell to clients on fixed incomes.
Preventive Care = Better Health
Most plans cover routine cleanings and X-rays at 100%. This encourages regular checkups and helps prevent expensive problems later. Clients appreciate plans that improve long-term health and reduce medical complications.
Affordable Premiums and Strong Benefits
Stand-alone dental plans typically offer:
- Low monthly premiums
- Basic and major service coverage
- Large provider networks
- Options to keep their current dentist
These features make dental plans simple to explain and highly attractive during enrollment discussions.
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A Reliable Cross-Sell Opportunity
Dental plans pair easily with Medicare Supplement, Medicare Advantage, and stand-alone Part D coverage. Adding dental boosts client satisfaction, increases retention, and creates additional commission opportunities; all while genuinely improving your clients’ coverage.
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Offering stand-alone dental coverage helps you close Medicare’s biggest gap, deliver real value, and grow your book of business. With strong consumer demand and affordable pricing, dental plans remain one of the easiest and most impactful products to present in every client conversation.
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Medicare Part B in 2026: What to Expect
Medicare beneficiaries will see several important changes to Medicare Part B 2026. Costs are rising again, and many retirees will feel the impact. Here is a simple breakdown of what’s changing and why it matters.
Key Cost Changes for 2026
The standard monthly Part B premium increases to $202.90 in 2026. This is a noticeable jump from the 2025 premium of $185.00. The annual deductible also rises. It increases to $283, up from $257 in 2025.
After you meet the deductible, you still pay 20% coinsurance for most Part B services. This includes doctor visits, outpatient care, therapy, lab work, and durable medical equipment. These basic cost-sharing rules do not change.
Why These Costs Are Going Up
Medicare adjusts Part B premiums each year. These changes reflect the rising cost of healthcare. More people are using outpatient services. Physician-administered drugs also continue to drive spending.
CMS noted that the increase could have been even higher. Cost-saving steps helped reduce the size of the jump. One example is new rules designed to slow spending on certain high-priced items, such as skin substitutes. Still, higher medical costs overall mean higher premiums for beneficiaries.
Click here to watch our YouTube video on Medicare Part B IRMA and IEP, SEP rules
What This Means for You
Higher premiums and a higher deductible mean higher yearly expenses. The extra $18 per month adds up. Over the course of a year, it is more than $200. This does not include the out-of-pocket costs you may pay when you receive care.
Budgeting becomes even more important in 2026. If you expect frequent doctor visits or outpatient treatments, you may face additional costs throughout the year.
For many people, supplemental coverage can help. Medigap plans can reduce out-of-pocket expenses. Medicare Advantage may also offer lower upfront costs. However, each option has different benefits and limits. It is important to compare them carefully.
Check Your Income Level
Some people will pay more than the standard premium. If your income is above certain thresholds, you may owe an Income-Related Monthly Adjustment Amount (IRMAA). This surcharge increases your monthly cost. It is based on your tax return from two years prior.
Medicare Part B costs will increase again in 2026. These changes affect almost every beneficiary. Reviewing your coverage now can help you avoid surprises later. Look at your budget, your health needs, and your income level. Then decide whether Original Medicare alone is enough or if a supplemental option makes sense for you.
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2026 Social Security COLA: What the 2.8% Increase Means for Beneficiaries
The Social Security Administration (SSA) has officially announced the 2026 Social Security COLA; beneficiaries will receive a 2.8% increase beginning in January 2026. This annual Cost-of-Living Adjustment is designed to help SSI recipients keep pace with inflation. Here’s a clear breakdown of what the new COLA means and how it affects monthly benefits.
How Much Will Social Security Benefits Increase in 2026
Thanks to the 2.8% COLA, millions of Americans will see higher monthly payments. Here are some average 2026 Social Security benefit amounts after the increase:
- Retired worker: Rises from about $2,015 to $2,071 (+$56 per month)
- Medicare aged couple (both receiving benefits): Increases to $3,208
- Widow(er) living alone: Goes up to $1,919
- Widowed parent with two children: Increases to $3,898
For SSI recipients, the 2026 federal benefit rate climbs to $994 per month for an individual and $1,491 for couples. In total, the COLA affects roughly 75 million beneficiaries nationwide.
These updated numbers are among the most searched details about the 2026 COLA, and they reflect the real-dollar impact on everyday retirees.
Understanding Other Social Security Changes in 2026
Beyond the COLA increase, beneficiaries should be aware of several important 2026 Social Security updates:
- The maximum taxable earnings limit will rise to $184,500.
- The 2026 earnings limit for individuals collecting benefits before full retirement age increases to $24,480.
- For those reaching full retirement age in 2026, the earnings limit will be $65,160.
These figures matter for anyone still working while collecting Social Security, as well as future retirees planning ahead.
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Why the 2026 COLA May Not Feel Like a Big Raise
Although the 2.8% COLA is larger than last year’s adjustment, many retirees may not feel the full benefit. That’s because:
- Medicare Part B premiums are rising in 2026, reducing take-home Social Security checks.
- Seniors face higher inflation in areas not reflected fully in the CPI-W, such as healthcare, housing, and utilities.
- For retirees who rely heavily on Social Security, a $56 monthly increase may provide only modest relief.
What Beneficiaries Should Do Now
To prepare for the new year, beneficiaries should:
- Review their 2026 net Social Security payment after Medicare deductions
- Update household budgets to account for higher costs of living
- Understand how the 2026 earnings limits may affect working retirees
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The 2026 Social Security COLA provides helpful income protection, but rising expenses mean beneficiaries should plan carefully
CMS Proposes Star Ratings Change for Medicare Advantage & Part D Plans
Federal regulators are moving to revamp the Medicare Advantage Star Ratings program, signaling a shift in how insurers’ performance is measured and rewarded. The Centers for Medicare and Medicaid Services CMS Proposes Star Ratings Change; they issued a draft regulation, opening the door for public input on potential changes to Medicare Advantage policies, risk adjustment, and even the Medicare Part D prescription drug program.
The proposed overhaul comes as insurers face mounting pressure from prior authorization requirements, audits, and marketing restrictions. By streamlining the Star Ratings system, CMS may offer plans some relief while keeping the focus on high-quality patient care.
Watch a YouTube video on the discontinued Medicare Advantage special enrollment period
What’s Changing in Star Ratings
The Star Ratings program has significant financial implications for insurers. CMS awards Medicare Advantage and Part D plans that score at least four stars with a 5% payment bonus. Under the draft rule, the agency proposes removing a dozen measures that focus on operational performance or administrative processes rather than clinical outcomes.
Of the changes, eight measures would affect only Medicare Advantage plans, two would apply only to Part D, and two would apply to both programs. Examples include removing metrics tied to appeal decision timeliness, customer service, and members’ decisions to leave a plan. CMS notes that these measures “don’t sufficiently convey variations in quality among plans.” Most of the changes would take effect for the 2029 plan year.
Health Equity Index Eliminated
CMS also proposes ending its Health Equity Index, a 2024 initiative that rewarded plans for improving care for marginalized populations. Instead, the agency would continue the existing reward factor that incentivizes high performance across measures.
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New Focus on Clinical Care
The draft regulation highlights CMS’s intent to refocus Star Ratings on meaningful clinical outcomes. For example, the agency plans to add a depression screening follow-up measure to Medicare Advantage, reflecting an emphasis on behavioral health.
“These proposed changes aim to refocus the program on clinical care, outcomes and patient experience where there is meaningful variation in performance across contracts,” CMS said in a news release.
What This Means for Insurers and Beneficiaries
Insurers could benefit from a simpler Star Ratings system, with less emphasis on administrative metrics. For beneficiaries, the changes signal a stronger focus on health outcomes and patient experience rather than operational benchmarks. The public now has a chance to weigh in on the proposals before CMS finalizes the rule.
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Wellabe Hospital Indemnity Plan Sales – An Opportunity for Medicare Agents
As Medicare Advantage benefits continue shifting and out-of-pocket costs trend upward, 2026 is shaping up to be a year where supplemental protection becomes more important than ever. That’s why Wellabe Hospital Indemnity plan sales are emerging as a strong add-on product. This is helpful for agents looking to boost client value, deepen relationships, and increase commissions all while solving real coverage gap issues for Medicare beneficiaries.
Below is an original, agent-focused breakdown of why Wellabe HI plans deserve a top spot in your sales strategy.
Why Hospital Indemnity Plans Matter in 2026
Even with Medicare Advantage coverage, your clients face unpredictable and sometimes steep costs when they’re admitted to a hospital. MA plans commonly include:
- Daily inpatient copays
- Emergency room copays
- Observation stay costs
- Ambulance fees
- Rising maximum out-of-pocket (MOOP) limits
Hospital Indemnity plans fill these financial gaps by providing cash benefits paid directly to the member, which can be used for anything; copays, transportation, lodging for family members, or simply covering monthly bills.
With many MA carriers adjusting benefits and tightening budgets for 2026, more clients are feeling the strain of increased cost-sharing. This shift creates a prime selling opportunity for Wellabe’s Hospital Indemnity Plan.
Why Agents Love Wellabe’s HI Product
Wellabe (formerly Great Western Insurance Company) has structured their HI plan to be flexible, easy to present, and competitive nationwide.
Simplified Issue for Most Ages
Clients can often qualify without medical exams or lengthy underwriting. Fast approvals mean a smoother sales process for both you and the client.
Highly Customizable Benefits
You can tailor benefits based on a client’s specific MA plan design. Options include:
- Daily hospital confinement benefits
- Ambulance coverage
- Observation stay riders
- Skilled nursing facility benefits
- ER coverage
- Lump-sum outpatient surgery benefits
This allows you to build a package that aligns perfectly with their needs.
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Affordable Monthly Premiums
Wellabe’s pricing remains competitive, especially for clients in their late 60s and early 70s. HI plans are one of the easiest cross-sell items because premiums are low and the value is easy to demonstrate.
Ideal Cross-Sell with Medicare Advantage
Whenever you review a client’s MA plan and see hospital copays or multi-day confinement fees, you have a natural opening to present Wellabe HI as a cost-protection solution.
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Sales Positioning That Works
Here are proven strategies you can use during AEP, OEP, or everyday sales conversations:
Create Security
Highlight the unpredictable nature of hospital expenses with MA plans. Clients appreciate having fixed, guaranteed cash benefits.
Protect Your Retirement Income
Explain how a short hospital stay could wipe out a month, or more, of income. A low-cost HI plan helps stabilize finances.
Match Benefits to Plan Gaps
Show them the exact hospital copay amounts in their MA plan and how a Wellabe HI benefit can cover it dollar-for-dollar.
Bundle Approach for Agents
Many agents use wording similar to the following:
“If you choose an MA plan, you might wan to consider pairing it with a Hospital Indemnity plan so your hospital costs are fully covered.”
This increases client satisfaction and reduces future complaints or surprise bills.
Why Selling Wellabe HI Plans Builds Long-Term Business
- Strong customer service and claims reputation
- Additional commission without added complexity
- Deepens your advisory role with every client and allows them to use one resources for their coverage needs
Clients who feel fully protected are less likely to shop around, helping you retain business year after year.
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Medicare Supplement Plan Sales Growth
As Medicare Advantage plans undergo major changes for 2026, more seniors are taking a closer look at Medicare Supplement (Medigap) coverage. With tighter MA budgets, reduced benefits, and growing network concerns, Medigap is becoming the go-to choice for beneficiaries who want simplicity, stability, and predictable healthcare costs. This has helped with Medicare Supplement plan sales growth.
Why Medicare Advantage Changes Are Driving the Shift
For 2026, many Medicare Advantage carriers are reducing cost-sharing perks, scaling back extras, and becoming more selective with enrollment growth. Factor in increased marketing scrutiny and commission pressure, and the MA landscape feels less predictable than it has in years.
Seniors are noticing; many are now reevaluating whether MA plans still fit their needs.
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Why Medicare Supplement Plans Stand Out in 2026
1. Predictable Costs and Simple Coverage
Medigap helps shield members from unexpected bills by covering the gaps in Original Medicare. Plan G and other popular options remain consistent year after year.
2. Freedom From Networks
Members can see any doctor or hospital nationwide that accepts Medicare; no referrals, no authorizations, and no surprises.
3. Long-Term Stability
While MA benefits change annually, Medigap benefits do not. This makes Medigap especially appealing amid shifting MA offerings.
How to Position Medigap in Your Sales Strategy
- Lead with predictability: Emphasize long-term cost stability compared to fluctuating MA benefits.
- Highlight provider freedom: Seniors frustrated with shrinking MA networks respond well to Medigap’s nationwide access.
- Target MA switchers: Many beneficiaries use the Medicare Advantage Open Enrollment Period to move into more stable coverage.
- Educate early: Start conversations before annual plan changes create confusion or frustration.
Watch a quick YouTube video on MA OEP best practices
Key Takeaways
- Medicare Advantage plans are cutting back on supplemental benefits and tightening networks for 2026.
- Medicare Supplement plans offer predictability, nationwide access, and long-term stability.
- Demand is increasing as seniors seek more control and fewer surprises.
- Agents can leverage this shift to build trust, long-term relationships, and stronger retention.
As Medicare Advantage plans tighten benefits in 2026, Medicare Supplement insurance stands out as a stable, reliable alternative. For agents, this shift presents a strong opportunity to guide clients toward coverage that offers flexibility, control, and predictable healthcare spending.
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Medicare Part B Enrollment Periods
Medicare Part B is a vital part of your healthcare coverage, helping to pay for doctor visits, outpatient care, preventive services, and medical supplies. However, knowing when to sign up is just as important as understanding what Part B covers. Enrolling at the right time ensures you avoid costly late penalties and gaps in coverage. Here’s a breakdown of the key Medicare Part B enrollment periods and what each means for you.
Initial Enrollment Period (IEP)
Your Initial Enrollment Period is your first chance to enroll in Medicare Part B. It lasts seven months — beginning three months before, including your birth month, and continuing three months after you turn 65.
- If you enroll before your birthday month, your Part B coverage starts the month you turn 65.
- If you enroll during or after your birthday month, coverage begins the month after you enroll.
Tip: Even if you’re still working, check with your employer’s HR department to see whether you should enroll right away or delay Part B to avoid duplicate coverage.
Special Enrollment Period (SEP)
If you or your spouse are still working past 65 and have employer-sponsored health coverage, you can delay enrolling in Part B without penalty. Once that coverage ends, you qualify for a Special Enrollment Period.
The SEP lasts eight months from the date your employment or group coverage ends — whichever comes first. Enrolling during this window ensures you don’t face the Part B late enrollment penalty, which can increase your premium by 10% for every 12 months you were eligible but didn’t sign up.
Important: COBRA or retiree coverage doesn’t count as active employer coverage, so your SEP clock may start ticking sooner than you think.
Watch a YouTube video on Medicare OEP, SEPs and Late Part B Enrolllments
General Enrollment Period (GEP)
If you missed both your Initial and Special Enrollment Periods, the General Enrollment Period gives you another chance. The GEP runs every year from January 1 to March 31.
- Coverage begins the first day of the month after you enroll.
- You may owe a late enrollment penalty added to your monthly premium for as long as you have Part B.
While this period can be a helpful safety net, it’s best to avoid relying on it if possible due to potential penalties and delayed coverage.
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Medicare Advantage (Part C) and Other Related Enrollment Periods
Once you have Part B, you can explore Medicare Advantage (Part C) or Medigap plans to supplement your coverage. Enrollment in these plans often depends on your Part B effective date, so timing your Part B enrollment correctly is crucial for coordinating your full Medicare coverage.
Understanding Medicare Part B enrollment periods can save you money and prevent headaches down the road. Whether you’re turning 65 soon, working past retirement age, or helping a loved one with their coverage decisions, planning ahead is key.
If you’re unsure when to enroll, a licensed Medicare agent can review your situation, explain your options, and help you avoid penalties or coverage gaps.
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Why Offer Cigna CHS Plans – A Smart Add-On for Today’s Medicare Market
Why offer Cigna CHS plans; in today’s shifting healthcare landscape, consumers are more concerned than ever about unexpected medical costs. This is especially true of those triggered by major health events like cancer, heart attacks, and strokes. For agents, this concern represents a major opportunity. Cigna’s Cancer, Heart Attack & Stroke (CHS) plans have quickly become one of the most valuable supplemental products to offer alongside Medicare Advantage, Medigap, and individual health insurance.
Here’s why CHS coverage should be part of your 2026 sales strategy.
CHS Plans Fill a Critical Financial Gap
Cancer, heart attacks, and strokes are among the costliest and most common medical events for U.S. adults. Even insured clients often face:
- High deductibles and co-pays
- Hospitalization charges
- Travel and lodging for treatment
- Lost income or caregiver costs
Cigna’s CHS plans provide a lump-sum cash benefit clients can use for anything; medical or non-medical. This flexibility allows families to stay financially stable during the most stressful moments of their lives.
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Cigna Offers Strong, Recognizable Branding
Cigna is a trusted national name, and clients feel confident purchasing protection from a carrier they already associate with quality and service. This instantly boosts your credibility and reduces objection rates that often happen with lesser-known supplemental carriers.
Simple, Streamlined Underwriting
Cigna’s underwriting for CHS plans are straightforward, agent-friendly, and designed for quick approvals. This makes CHS an easy add-on during:
- Medicare Advantage reviews
- Medigap comparisons
- ACA Special Enrollment conversations
- Life insurance appointments
Faster underwriting means more closed sales and fewer follow-ups.
Competitive Premiums & High Value for the Client
CHS premiums remain very affordable; even for clients on a fixed income. For many households, adding this coverage costs less per month than common streaming subscriptions. Yet the payout during a claim can be life-changing.
For agents, this creates a high-value, low-resistance product that clients appreciate and rarely cancel.
A Perfect Cross-Sell During Annual Reviews
If you’re an active Medicare agent, you’re already meeting clients every year. CHS coverage fits seamlessly into that conversation:
“Your current plan looks good, but let’s also talk about financial protection if something major happens.”
These products can add revenue, boost client retention, and strengthen your role as a full-service advisor.
Easy to Explain, Easy to Sell
You don’t need complex charts or benefit summaries. Clients understand cancer, heart attacks, and strokes; they’ve seen friends, family, or coworkers experience them. The product is relatable and instantly makes sense.
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Helps Protect Your Book of Business
When you offer supplemental solutions that truly help clients, they are far more likely to stay with you long-term. CHS adds stickiness to your business and positions you as a proactive agent who delivers value, not just someone who enrolls clients into a single plan.
Cigna’s Cancer, Heart Attack & Stroke plans are one of the simplest and most impactful products you can add to your portfolio in 2026. They support your clients, improve financial security, and create a reliable revenue stream for your business.
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If you’re looking for a product that offers strong benefits, easy conversations, and meaningful protection; Cigna CHS is a must-have in your lineup.
Medicare Costs 2026: What Beneficiaries and Agents Need to Know
As Medicare undergoes significant shifts in 2026, beneficiaries will face new premiums, deductibles, and cost-sharing structures. These costs impact how they access and budget for care. For agents, understanding these changes is essential for guiding clients through enrollment decisions and helping them prepare for the year ahead. Here’s a breakdown of important Medicare cost updates for 2026 and what they mean for the people you serve.
Higher Costs Driven by Utilization and Program Changes
Several factors are driving cost increases across Medicare Part A and Part B in 2026:
- Greater healthcare utilization: Hospital and outpatient visits continue to rise.
- Higher reimbursement requirements: Centers for Medicare & Medicaid Services (CMS) is adjusting payments to hospitals, physicians, and Medicare Advantage plans due to inflation and increased care complexity.
- Changes in Medicare Advantage rules: Policy shifts for 2026; including tighter oversight and reduced supplemental benefit flexibility, are indirectly affecting Original Medicare spending trends.
While Medicare costs rise most years, 2026 brings a more noticeable increase driven by combined economic and regulatory pressures.
Medicare Part A Costs for 2026
Most beneficiaries still receive Part A with no monthly premium (if they qualify via work-history) but other Part A cost-sharing amounts are increasing:
- Inpatient hospital deductible (Part A): For 2026 the deductible for a benefit period is $1,736, up from $1,676 in 2025.
- Daily coinsurance for days 61–90 in hospital: $434 per day in 2026, up from $419.
- Lifetime reserve-day coinsurance: $868 per day in 2026.
- Skilled Nursing Facility (SNF) coinsurance (days 21-100): $217 per day in 2026, up from $209.50.
Agents should remind clients that even if Part A premium is “free,” they can still face significant out-of-pocket exposure via hospital stays and extended care—making Medigap or a well-selected Medicare Advantage plan even more important.
Medicare Part B Costs for 2026
Part B sees some of the most direct increases:
- Standard monthly premium (Part B): $202.90 per month in 2026 (up from $185.00 in 2025).
- Annual deductible (Part B): $283 in 2026 (up from $257 in 2025).
- Income-related monthly adjustment amounts (IRMAA): Beneficiaries with higher incomes will pay more than the standard premium; for 2026 the standard premium applies to individuals with a modified adjusted gross income (MAGI) up to $109,000 (or $218,000 for joint filers)
For agents, breaking down these numbers early in AEP and during SEP conversations helps clients avoid sticker-shock and budget accurately.
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Prescription Drug Costs
- The annual deductible for the standard Part D benefit in 2026 is $615.
- Beneficiaries will pay cost-sharing (typically coinsurance) during the initial coverage phase until their true out-of-pocket (TrOOP) drug spending hits $2,100 for 2026. At that point, the plan pays 100% of covered drugs for the rest of the year.
- All 2026 Part D plans are required to include this $2,100 cap.
- For beneficiaries with very high drug costs, this cap provides meaningful protection, limiting their maximum annual out-of-pocket prescription drug expense (excluding premiums).
Learn more about the drug cap – watch a YouTube video
Medicare costs are rising in 2026; with thoughtful planning, beneficiaries and their agents can manage these changes with confidence. By staying informed and proactively communicating updates, agents stand out as trusted, knowledgeable guides.