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How are Medicare benefits changing for 2026?
Changes to 2025 Medicare coverage include a $2,000 cap on Part D out-of-pocket costs, small reductions in the average premium for Medicare Advantage and Part D plans, increases for Medicare Part B and Part A premiums and cost-sharing, and adjustments to income-related premium surcharges for Part B and Part D.
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What is the income-related monthly adjusted amount (IRMAA)?
For 2025, high-income beneficiaries – earning over $106,000 a year – pay an IRMAA surcharge that’s added to their Part B and Part D premiums and determined by income from their income tax returns two years prior.

waiting period

What is a waiting period?

medicareresources.org Glossary

What is a waiting period?

Under the terms of some health plans, potential enrollees must wait a defined period of time before they are eligible for enrollment after starting a new job, or for coverage of pre-existing conditions.

For most types of Medicare coverage, there is no waiting period, meaning people can enroll as soon as they’re eligible and there are no waiting periods before pre-existing conditions are covered.

This is true for Original Medicare (Parts A and B), Medicare Advantage, and Medicare Part D.1 But Medigap plans can have waiting periods of up to six months before pre-existing conditions are covered, if the enrollee had a gap in coverage before enrolling in the Medigap plan.2

Medigap insurers can also reject an application altogether or impose a higher premium due to the applicant’s medical history, if the application is submitted after the person’s initial enrollment period has ended and outside of a guaranteed-issue special enrollment period. In most states, there is no annual open enrollment period for Medigap plans.3

Footnotes

  1. Does Medicare cover pre-existing conditions?” The Checkup by SingleCare. Sep. 30, 2022 
  2. Does Medicare cover preexisting conditions?” Humana. May 20, 2025 
  3. Get ready to buy
    Your Medigap Open Enrollment Period” Medicare.gov. Accessed May 28, 2025 
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