Medicare Advantage and Part D Updates: What You Need to Know About the CY 2026 Changes

The Centers for Medicare and Medicaid Services (CMS) has finalized the changes to Medicare Advantage and Part D for the 2026 calendar year (CY). The updates aim to improve the quality and accessibility of healthcare services for Medicare beneficiaries. In this article, we will delve into the key changes and what they mean for those enrolled in Medicare Advantage and Part D plans.

Background

Every year, CMS reviews and updates the regulations governing Medicare Advantage and Part D plans. These updates are designed to ensure that beneficiaries receive high-quality, affordable healthcare. The CY 2026 changes are the latest in a series of updates aimed at improving the Medicare program.

Key Changes to Medicare Advantage

The CMS has finalized several changes to Medicare Advantage plans, including: Expansion of Telehealth Services: Medicare Advantage plans will be required to cover more telehealth services, making it easier for beneficiaries to access healthcare from the comfort of their own homes. Improved Network Adequacy Standards: The CMS has strengthened network adequacy standards to ensure that beneficiaries have access to a sufficient number of healthcare providers. Enhanced Beneficiary Protections: The updates include new protections for beneficiaries, such as increased transparency around plan benefits and costs.

Key Changes to Part D

The CMS has also finalized changes to Part D plans, including: Simplified Pharmacy Networks: Part D plans will be required to have more straightforward pharmacy networks, making it easier for beneficiaries to find participating pharmacies. Increased Transparency Around Prescription Drug Costs: The updates include new requirements for Part D plans to provide more detailed information about prescription drug costs and coverage. Improved Access to Specialty Drugs: The CMS has taken steps to improve access to specialty drugs, which are often used to treat complex or rare conditions.

What Do the Changes Mean for Beneficiaries?

The CY 2026 changes to Medicare Advantage and Part D plans are designed to improve the quality and accessibility of healthcare services for beneficiaries. With the expansion of telehealth services, beneficiaries will have more options for accessing healthcare from home. The improved network adequacy standards and enhanced beneficiary protections will also help to ensure that beneficiaries receive high-quality care. The CMS has finalized the changes to Medicare Advantage and Part D plans for the 2026 calendar year. The updates aim to improve the quality and accessibility of healthcare services for Medicare beneficiaries. By understanding the key changes to these plans, beneficiaries can make informed decisions about their healthcare coverage and take advantage of the new benefits and protections. As the Medicare program continues to evolve, it's essential to stay up-to-date on the latest updates and changes.

Download the PDF version of the CY 2026 changes to Medicare Advantage and Part D for more information.

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