Medicare Plan Changes in 2026: What Bend Residents Should Know

The biggest Medicare changes for 2026 are in your costs: a higher Part B premium and deductible, a $2,100 yearly cap on Part D drug spending, and plan-by-plan shifts in Medicare Advantage that only your own plan letter will spell out. If you live in Central Oregon, there is one more piece: Oregon’s Medigap birthday rule lets many people switch supplement plans without health questions, which can matter more than any national headline.

It is also October 2026, so Open Enrollment is underway. This guide covers what changed this year, what it means for each type of coverage, and what to do before December 7.

TL;DR

• Part B costs rose in 2026: the standard premium is $202.90 a month and the deductible is $283.
• Part D now caps what you pay out of pocket at $2,100 for the year, and plan deductibles can be no higher than $615.
• Medicare Advantage is stable nationally, but individual plans change every year, and Deschutes County has seen insurers leave. Read your Annual Notice of Change.
• Oregon’s birthday rule gives you a guaranteed right to switch Medigap plans each year, if you apply within 60 days around your birthday.

Table of Contents

• What changed in Medicare costs for 2026
• Part D: the $2,100 cap and what it does and doesn’t do
• Medicare Advantage in 2026
• Your plan letter matters more than the headlines
• Medigap and Oregon’s birthday rule
• Our perspective: what we tell neighbors in Bend
• A short checklist for Open Enrollment
• Talk it through with a local agent
• FAQ
• Sources

What changed in Medicare costs for 2026

Start with Original Medicare, since everything else is built on it. Medicare’s own cost publication lists the 2026 numbers:

These figures come from Medicare’s 2026 costs publication. Most people pay nothing for Part A because they or a spouse paid Medicare taxes long enough while working, generally at least 10 years, as Medicare’s cost page explains.

The Part B premium is usually taken from your Social Security check. If your income was higher two years back, you may also pay an income-related surcharge known as IRMAA. We cover the brackets in our guides on the 2026 Part B premium and Medicare IRMAA. If your income has dropped since then, for example after retiring, that is worth raising with Social Security.

Part D: the $2,100 cap and what it does and doesn’t do

The Part D redesign is the change most people notice at the pharmacy counter. In 2026, once your covered drug spending reaches the $2,100 out-of-pocket threshold, you pay $0 for covered drugs for the rest of the calendar year. The same CMS document sets the maximum Part D deductible at $615, up from $590 in 2025. Plans may charge less, and some charge no deductible at all.

Medicare describes three stages in a drug plan: a deductible stage if your plan has one, an initial coverage stage, and a catastrophic stage. Medicare’s Part D cost page walks through each.

Why the cap isn’t the whole story

The cap limits what you pay for drugs on your plan’s formulary. It does not cover drugs your plan excludes, and it does not limit your monthly premium. Two plans with the same $2,100 ceiling can still cost very different amounts over a year depending on:

• the monthly premium,
• the deductible (anywhere from $0 up to $615),
• whether your drugs sit on a low-cost tier,
• whether your pharmacy is in the plan’s preferred network.

If you take expensive brand-name medications, the cap is a real safety net. If you take a few generics, a plan with a low premium and no deductible may cost you less than any cap would suggest. Our article on the 2026 Part D deductible shows how to compare.

People managing diabetes often feel the Part D changes most, since insulin, sensors and testing supplies can be split between Part B and Part D depending on the item. For a practical look at the prescription side, see how diabetes supply prescriptions work in 2026. Ask your pharmacist which of your items bill to which part before assuming a cost.

Medicare Advantage in 2026

Nationally, Medicare Advantage held steady. CMS reported that 99% of beneficiaries have access to a plan, that the average monthly premium was expected to fall to $14.00 from $16.40 in 2025, and that the number of plans slipped slightly from 5,633 to roughly 5,600. Supplemental benefits such as dental, vision and hearing stayed broadly available.

National averages hide local reality. In Central Oregon, the Medicare Advantage market has been thin and shifting. KTVZ reported that an insurer was ending its Medicare Advantage plan for Deschutes County residents as of January 1, leaving few choices and raising questions about whether the remaining plan would keep its local hospital in network. If you live here, plan availability and your doctors’ network status deserve more attention than the national premium average.

Dental, vision and the fine print

Advantage plans often advertise dental and vision, but the annual dollar caps vary widely and can run out fast with a crown or implant. Our piece on Medicare Advantage dental in 2026 shows what to check. If the cap is too low for your needs, a standalone plan may fit better. We help with both dental and vision coverage.

Out-of-pocket maximums

Advantage plans have a yearly limit on what you pay for in-network covered services, and it differs plan to plan. Original Medicare has no such limit, which is why many people pair it with a Medigap policy. See our breakdown of 2026 out-of-pocket caps in Central Oregon.

Your plan letter matters more than the headlines

Every fall, your plan mails an Annual Notice of Change (ANOC). It spells out exactly how your plan’s costs, benefits and provider network change for the coming year. Medicare’s yearly review guide says Open Enrollment runs October 15 to December 7 and is the time to review your health or drug coverage and decide whether to change.

A plan that suited you last year may not suit you next year. When you open the letter, check three things:

1. Your drugs. Are they still on the formulary, and on the same tier?
2. Your doctors and hospital. Are they still in network?
3. Your total cost. Premium plus deductible plus copays for what you actually use, not the premium alone.

We go deeper in Annual Notice of Change: 3 checks before Open Enrollment.

Medicare’s Plan Finder tool lets you enter your medications and compare personalized costs, which beats relying on a plan’s marketing mailer.

If you get a non-renewal notice

This is different from a routine change. A Plan Non-Renewal Notice arrives in October when your plan is leaving Medicare for the coming year. You must find a new plan. If you do nothing by December 7, you risk being moved to Original Medicare, which may leave you without drug coverage. Treat that letter as urgent and act the week it arrives.

Medigap and Oregon’s birthday rule

Medigap, or Medicare Supplement, covers many of the costs Original Medicare leaves behind. Its premiums tend to rise as you age and as insurers adjust rates. That’s where Oregon offers an unusual advantage.

Under the Oregon Division of Financial Regulation’s birthday rule fact sheet, you can switch supplement policies each year. The window opens 30 days before your birthday and closes 30 days after. The switch is guaranteed issue: the company can’t turn you down or charge more because of your health. The rule applies to Medigap policies issued after January 1, 1990, but not to self-funded employer group plans, which are not eligible.

What to know before you switch

• Same or lesser benefits only. You can move to a plan with the same or fewer benefits than your current one. For example, someone with Plan F can switch to any 2010-standardized Plan A through N, per Oregon’s matrix.
• High-deductible plans restart. If you hold a High Deductible Plan F and switch to another high-deductible policy, the annual deductible starts over under the new contract. People often overlook this.
• Don’t cancel first. Keep your current policy until the new one is formally issued. Oregon’s guidance notes that the new coverage can take effect as early as the first of your birthday month, and the state can adjust the effective date so you don’t hold two active policies. Paying two premiums for a single month is common and prevents a gap.

For step-by-step detail, see our guides on the 60-day window and switching Medigap plans in Central Oregon. If you’re new to Medicare and still inside your first six months on Part B, a different, stronger protection applies; read choosing a Medigap plan in Oregon and Medigap preexisting conditions.

The state’s own fact sheet is blunt about the point of the rule: it protects you from being stuck in a policy whose rates keep climbing. Comparing prices every birthday month is the habit that makes it work.

Our perspective: what we tell neighbors in Bend

We are a local agency, and the question we hear most in the fall is some version of “Did Medicare change on me?” The honest answer is that the national rules changed a little and your plan may have changed a lot.

Here is how we think about it. First, the headline numbers (the Part B premium, the Part D cap) apply to everybody, so there’s nothing to shop for. Second, everything that can actually save you money is plan-specific: your drug list, your doctors, your supplement premium. That’s why we start with your letter, your medication list and your doctors, not with a plan we want to sell.

Third, we think most people should look at their Medigap price once a year around their birthday, even if they’re happy. Oregon gives you a right that many states don’t, and unused rights don’t help anyone. Sometimes the answer is to stay put, and we’ll say so. Our consultations are free and educational, and we’re paid by the carrier only if you decide to enroll through us. You can walk away with the information either way.

Finally, we’d rather you hear about a deadline from us in October than discover it in January. If something in a letter looks alarming or confusing, bring it in or send us a photo.

— Jesse Zimmerman

A short checklist for Open Enrollment

Between now and December 7:

1. Find your ANOC or non-renewal letter and read the changes section first.
2. List every medication, dose and pharmacy you use.
3. List your doctors and the hospital you’d want to use.
4. Run your drugs through the Medicare Plan Finder.
5. If you have Medigap, note your birthday and the dates 30 days either side of it.
6. Decide on any change before December 7, and confirm the new plan’s start date of January 1.

If you want a second set of eyes, our annual Medicare plan reviews are built for exactly this. Turning 65 soon? Our step-by-step Medicare guide covers the enrollment timeline, and we offer enrollment assistance if you’d like help with the paperwork.

Talk it through with a local agent

Mountaintop Insurance is a Bend agency that helps Central Oregon residents with Medicare Parts A, B, C and D, Medigap and the Oregon birthday rule, plus dental and vision. Consultations are free, in person or remote, and focused on explaining your options. Visit our Medicare Supplement page or start at our home page to book a time.

FAQ

Are Medicare Advantage plans going away in 2026?

Not nationally. CMS reported that 99% of beneficiaries have access to a plan and the plan count dipped only slightly. Individual plans do leave specific counties, including Deschutes County, so check your own letter.

How much is the Part D cap in 2026?

Once you reach $2,100 in out-of-pocket spending on covered drugs, you pay nothing more for them for the rest of the year. The cap doesn’t include your premium, and it doesn’t apply to drugs your plan doesn’t cover.

Can I switch Medigap plans without health questions in Oregon?

Often yes. Under the birthday rule you can move to a plan with the same or lesser benefits within the window from 30 days before to 30 days after your birthday, regardless of health. Self-funded employer group plans are excluded.

What should I do if my plan sends a non-renewal notice?

Choose a new plan before December 7. If you don’t, you may be moved to Original Medicare and could lose drug coverage. Contact a licensed agent or Medicare right away so you can compare what’s available in your county.

Sources

• Medicare costs 2026 (Medicare.gov)
• Medicare costs overview (Medicare.gov)
• Final CY 2026 Part D Redesign Program Instructions (CMS)
• How much does Medicare drug coverage cost? (Medicare.gov)
• Medicare Advantage and Part D expected to remain stable in 2026 (CMS)
• Another Medicare Advantage provider pulls out of local market (KTVZ)
• Your Yearly Medicare Review (Medicare.gov)
• Plan Non-Renewal Notice (Medicare.gov)
• Birthday Rule Fact Sheet (Oregon SHIBA)
• When can you switch Medigap plans (Oregon DFR)

Recommended

• 2026 Medicare Part B Premium: What Seniors Must Know
• $2,100 Part D Cap: Medicare Open Enrollment 2026 for Central Oregon
• Medicare AEP 2026: Key Dates, Rules, and What’s New
• Oct 15–Dec 7 Deadline: Medicare OEP 2026 for Central Oregon Enrollment

Disclaimer: This article is for general educational purposes only and does not constitute personalized advice. Medicare rules and plan details change frequently.