Medicare Supplement
Medicare AEP Changes Take Effect January 1 in Provo
PROVO, Utah — The clock is ticking on Medicare's Annual Enrollment Period. From October 15 through December 7, people with Medicare can review their coverage for 2026 and make changes that take effect January 1. If you live in Provo, this is the stretch of the year when the decisions you make — or skip — will shape your costs and access to care for the next 12 months.
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Key takeaways
- Medicare's Annual Enrollment Period runs from October 15 through December 7, and any changes made during this time start January 1, 2026.
- This is the first full open enrollment under a redesigned Part D drug benefit, so it's worth checking your coverage even if you're satisfied with your current plan.
- People already enrolled in a Medicare Advantage or Part D plan should have received an Annual Notice of Change in September, which explains changes to premiums, deductibles, drug tiers, provider networks, and prior authorization rules for 2026.
- For 2026, IRMAA surcharges on Part B and Part D premiums begin above $109,000 in modified adjusted gross income for a single filer, based on 2024 tax returns, though people with a life change like retirement or divorce can request a reconsideration using Form SSA-44.
This season is also the first full open enrollment under a redesigned Part D drug benefit. Here's what to know, and what you can actually do before the December 7 deadline.
Why 2026 looks different
A few program-level changes make this year worth a careful look, even if you're happy with your current plan:
- A new $2,100 out-of-pocket cap on Part D drugs. Once your covered drug spending hits that limit in 2026, you pay $0 for the rest of the year on covered prescriptions.
- The Part D deductible can be no higher than $615 in 2026. Plans can set it lower.
- The old "donut hole" is gone. Part D now has three phases — deductible, initial coverage, and catastrophic — instead of four.
- The Medicare Prescription Payment Plan lets you spread your yearly drug costs into monthly payments through your plan, at no added cost. It's optional, and you have to opt in.
None of that changes automatically for you unless you check your plan. Which brings us to the checklist.
What you can actually do between now and December 7
During the Annual Enrollment Period (AEP), you can:
- Switch from Original Medicare to a Medicare Advantage plan, or vice versa.
- Join, switch, or drop a Part D prescription drug plan.
- Change from one Medicare Advantage plan to another.
Any change you make now takes effect January 1, 2026. After December 7, your options narrow — Medicare Advantage members get a separate window from January 1 to March 31 to switch Advantage plans or return to Original Medicare, but Part D changes generally close.
Read your Annual Notice of Change
If you're already in a Medicare Advantage or Part D plan, you should have received an Annual Notice of Change (ANOC) in September. It spells out what's different for 2026 — premium, deductible, drug tiers, provider network, prior authorization rules.
Two things worth checking carefully:
1. Your prescriptions. A drug that was covered this year may move to a higher cost tier, require prior authorization, or drop off the formulary entirely. 2. Your doctors and hospitals. Medicare Advantage networks change. Confirm your primary care doctor, any specialists, and the hospital you'd want to use are still in-network for 2026.
Plan availability in Utah County
Provo sits in Utah County, and Medicare plan availability is set at the county level — meaning every Provo resident has the same menu of Medicare Advantage and Part D options as their neighbors elsewhere in the county. When you use the Plan Finder at Medicare.gov, enter your ZIP code and it will pull the plans available in Utah County.
CMS publishes annual counts of how many Medicare Advantage plans and stand-alone Part D plans are offered in each county. For an accurate 2026 count in Utah County, the Medicare.gov Plan Finder is the source of truth — it updates as carriers finalize offerings.
A word on income and IRMAA
If your income is higher than average, you may pay an Income-Related Monthly Adjustment Amount (IRMAA) on top of your Part B and Part D premiums. For 2026, IRMAA surcharges begin above $109,000 in modified adjusted gross income for a single filer (higher for joint filers), based on your 2024 tax return. If you had a life change — retirement, loss of a spouse, divorce — you can ask Social Security to reconsider using Form SSA-44.
What Star Ratings are (and aren't)
You'll see plans labeled with Star Ratings from 1 to 5. Medicare uses these to measure things like customer service, member complaints, and how well plans manage chronic conditions. Ratings are one input among many — they don't tell you whether a plan covers your drugs or includes your cardiologist. Use them as context, not a shortcut.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in Utah County
(MA penetration in Utah County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
Key dates
Medicare enrollment periods at a glance
- Around your 65thInitial Enrollment PeriodA 7-month window around the month you turn 65 — your first chance to sign up.
- October 15 – December 7Annual Enrollment PeriodAnyone with Medicare can join, switch, or drop a Medicare Advantage or Part D plan.
- January 1 – March 31Medicare Advantage Open EnrollmentIf you're already in a Medicare Advantage plan, you can make one change.
- January 1 – March 31General Enrollment PeriodFor people who missed their first chance to sign up for Part B.
- VariesSpecial Enrollment PeriodTriggered by life events like moving or losing other coverage.
Dates are set by Medicare and apply nationwide. Confirm your personal windows at Medicare.gov or 1-800-MEDICARE.
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The parts of Medicare
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When can you enroll? An interactive year
Enrollment windows are federal and the same nationwide. Confirm your personal dates at Medicare.gov or 1-800-MEDICARE.
Good to know
Frequently asked questions
What if I miss December 7?
Do I need to do anything if I like my current plan?
Is the $2,100 drug cap automatic?
- CMS — Medicare basics (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.