Medicare Changes in 2026: Everything Tampa Bay Area Residents Need To Know
Yes, we are talking about 2026, and before you know it, it will be here. This is the article you need to read if you have Medicare. In this article, “Medicare Changes in 2026: Everything Tampa Bay Area Residents Need To Know,” we will explain what you need to know so you are up-to-date.
IMPORTANT NOTE: This article is a living article that will be automatically updated as new information or numbers are released by the Centers for Medicare and Medicaid Services (CMS).
Rising Premiums and Deductibles: What Tampa Bay Seniors Can Expect
Most talked-about Medicare changes for 2026 involve increases in premiums and deductibles, particularly for Medicare Part B (which covers doctor visits, outpatient care, and preventive services) and Part D (prescription drugs). According to recent announcements, Medicare Part B premiums are projected to rise.
Medicare Part B will go up again
- In 2026, the standard monthly premium is $202.90, up $17.90 from 2025.
- The Medicare Part B deductible for 2026 is $283. This is an increase of $26 from 2025. This annual deductible applies to all Part B beneficiaries and covers the initial costs for medical services before Original Medicare begins to pay its share.
High earners will pay more. The income-related monthly adjustment amount (IRMAA) is a surcharge for people with income above a certain amount that must be paid in addition to their Medicare Part B and Part D premiums. The IRMAA is calculated every year. That means if your income is higher or lower year after year, your IRMAA status can change. If the SSA determines you must pay an IRMAA, you’ll receive a notice with the new premium amount and the reason for the determination.
Medicare Part A also set to increase!
- If you have Original Medicare, your 2026 Part A deductible will be $1,736 per benefit period. This is an increase of $60 from 2025. This deductible covers the costs for the first 60 days of inpatient hospital care.
- If you are hospitalized for more than 60 days, your coinsurance amount will $434 per day. That is an increase of $15 per day from 2025. You will pay this amount for every day that you are in the hospital between days 61st and 90th.
- If you are hospitalized for more than 90 days, your coinsurance amount will $868 per day in 2026. That is an increase of $30 per day from 2025. These are called your “Lifetime Reserve Days“.
- If you go into a skilled nursing facility and you have Original Medicare, you will not have to pay anything for the first 20 days. If you are still in the facility after the first 20 days, you will have to pay a $217 copayment for any days between 21 and 100. That is a small increase of $7.50 per day from 2025.
Reminder: Medicare does not cover long-term care. It also does not cover most non-medical personal expenses, such as custodial care that helps with daily activities, such as eating and bathing.
✅ Major Reforms to Medicare Part D: Lower Out-of-Pocket Caps and Payment Plans
Perhaps the biggest headline for 2026 is the ongoing implementation of the Inflation Reduction Act (IRA) provisions, which continue to reshape prescription drug coverage. The out-of-pocket maximum for Medicare Part D plans will increase slightly to $2,100, up from $2,000 in 2025, due to inflation.
Once you hit this cap, you’ll pay nothing more for covered drugs for the rest of the year, a huge relief for those with chronic conditions requiring expensive medications.
Another exciting update is the expansion of the Medicare Prescription Drug Payment Plan, which allows beneficiaries to spread their drug costs over the year in predictable monthly payments.
For example, let’s say your drugs take you over the $2100 limit. Instead of paying a huge bill the first time you go to the pharmacy, you can enroll in the payment plan and pay $167 per month. It’s like layaway, but you get your drugs immediately.
To make enrollment in the program easier in 2026, participants in 2025 will be automatically reenrolled unless they opt out or switch to a new Part D or Medicare Advantage plan. If you change your mind and want to continue on a payment plan, contact your new drug plan.
The Extra Help program (Low-Income Subsidy) is also expanding, making it easier for low-income individuals to qualify for reduced or zero premiums and deductibles. The best way to see if you qualify is to apply. Social Security will tell you everything you qualify for.
Medicare Advantage (Part C) Updates: Opportunities and Challenges in Florida
Medicare Advantage plans, popular in the Tampa Bay area for their extra benefits like dental, vision, and gym memberships, will see several tweaks in 2026. CMS has finalized a 5.06% average benchmark payment increase for MA plans, injecting over $25 billion in new funding. This could lead to more robust offerings from carriers like UnitedHealthcare, Humana, and Aetna, which MyPhss represents as an independent broker.
A positive change for Florida residents: Starting in 2026, Medicare Advantage, Medicaid, and ACA plans must provide decisions on urgent medical procedures within 72 hours. This speeds up prior authorizations, reducing delays for critical care, which is vital in areas like Pasco County, with its growing senior population.
However, average MA premiums might edge up slightly, and some plans could adjust benefits to manage costs. In Tampa Bay, where hurricanes and flooding can disrupt access to healthcare, choosing a plan with strong network coverage in Hillsborough or Pinellas is crucial. Additionally, enhanced provider directory requirements will make it easier to find in-network doctors.
How to Prepare for 2026 Medicare Changes in the Tampa Bay Area
To make the most of these updates, start by reviewing your current plan during your Annual Enrollment Period, which is from October 15 to December 7. Here’s a quick checklist tailored for local residents:
- Assess Your Needs: Consider your health conditions and frequent providers. If you live in Manatee County and need dental coverage, look for MA plans with strong extras.
- Compare Options: Use tools like the Medicare Plan Finder or MyPhss’s free quote tool at MyPhss.com to compare Part D plans, especially with the new cap.
- Budget for Increases: Factor in higher Part B premiums—projected around $185 monthly for standard beneficiaries—and rising deductibles.
- Explore Payment Plans: If drug costs are high, consider enrolling in the Prescription Payment Plan to alleviate upfront financial burdens.
- Seek Personalized Advice: House calls are our specialty at MyPhss. We serve the entire Tampa Bay region, from Hernando to Polk, with in-home consultations.
>> Don’t forget: Changes made during the 2025 Annual Enrollment Period take effect January 1, 2026.
Why Choose MyPhss for Your 2026 Medicare Needs
Here in the Tampa Bay area, Pasco, Hernando, Hillsborough, Pinellas, Citrus, and Polk counties, plan availability and provider networks can vary by neighborhood. We stay focused on the exact plan types that fit your doctors, pharmacies, and budget. You can click on the next image, and it will take you to our calendar where you can pick a date and time that works best for you.
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I intended to address most of your questions in this article, but if I missed anything, please email me at daniel@myphss.com, and I will be happy to answer your question.