Medicare Has Changed This Year, and Not Everyone Will Be Happy About It

Every new year brings several changes to key government programs. Whether it's Social Security, Supplemental Security Income(SSI), Medicaid, or Medicare, there's no shortage of information to stay updated.

In some cases, these changes work out in people's favor (like Social Security's cost-of-living adjustment). Unfortunately, in other cases, it's a change people would have rather done without. Beginning in 2026, a few Medicare changes are likely to fall into the latter category.

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Medicare recipients will pay more out-of-pocket

Paying into the Medicare system doesn't guarantee free health insurance in retirement; it comes with deductibles and premiums like standard health insurance. Unfortunately, both are going up this year.

The deductible for Part A (hospital insurance) is increasing by $60 to $1,736, and the deductible for Part B (medical insurance) is increasing by $26 to $283. This means Medicare beneficiaries will be responsible for more costs before the insurance kicks in.

Part A is premium-free for people who worked at least 10 years (40 quarters), or have a spouse who did. People with 30 to 39 quarters of work will have a $311 premium, a $26 increase from 2025. People with less than 30 quarters of work will have a $565 premium, a $47 increase from 2025.

The premium for Part B is increasing by $17.90 to $202.90. If you're single and earn over $109,000, or married and filing jointly and earn over $218,000, you could be subjected to the Income-Related Monthly Adjustment Amount (IRMAA) surcharge. It applies to Part B and Part D premiums and can be up to $487 (Part B) and $91 (Part D).

Medicare is cutting back on a popular service

Telehealth services surged in popularity during the COVID-19 pandemic, and Medicare loosened its requirements. Now, it's tightening its grip on telehealth coverage again.

Starting Jan. 31, beneficiaries must be in a physical medical facility and in a rural area to have telehealth services covered. If you're using telehealth for services like kidney disease care, drug abuse treatment, or behavioral health services, you're still covered, but most telehealth services will no longer qualify.

For people who had gotten used to the convenience of telehealth, this can be an added burden in many cases.

Beneficiaries will need preauthorization before more procedures

Starting this year, Medicare began a program called Wasteful and Inappropriate Service Reduction (WISeR), aimed at reducing fraud and "wasteful" spending. There are six pilot states -- Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington -- currently undergoing the program.

One of the biggest changes with WISeR is that many more procedures and devices will now need preauthorization before the plan covers them. Having to go through the preauthorization phase can cause delays and additional hurdles, which you can imagine people won't be happy about doing.

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