Medigap vs Medicare Advantage: What Changed in 2026 and How to Choose Wisely

Choosing between Medigap and Medicare Advantage plans in Connecticut has always been a critical decision for retirees, but 2026 brings significant changes that make it more important than ever to review your options. Here’s what you need to know about the latest updates and how to make the best choice for your healthcare needs.

Medicare Advantage Plans Connecticut: What’s New?

• Increased Funding and Payment Updates: Government payments to Medicare Advantage (MA) plans are set to rise by an average of 5.06% from 2025 to 2026, strengthening the program and supporting access to high-quality, affordable healthcare.
• Out-of-Pocket Maximums Lowered: The maximum out-of-pocket limit for in-network services under Medicare Advantage will decrease to $9,250 in 2026, down from $9,350 in 2025. Most plans, however, set their caps below this maximum.
• Plan Availability Changes: Some insurers are exiting or reducing their service areas in 2026, which may affect your current coverage. If your plan is discontinued, you’ll have the opportunity to select a new Medicare Advantage plan during the annual enrollment period.
• Prescription Drug and Preventive Care Enhancements: The 2026 rules introduce lower caps on prescription drug costs, free coverage for recommended adult vaccines, and capped insulin costs at $35 or 25% of the negotiated price—whichever is lower.
• Faster Care Approvals: Medicare is piloting AI-powered systems to speed up prior authorizations, reducing delays for important treatments in select states.

Medigap (Medicare Supplement) Changes in 2026

• Transition to MedigapFreedom Products: Starting January 1, 2026, new retirees from group plans must enroll in MedigapFreedom products. Enrollment in older MedigapSecurity and 65 Special products will no longer be available for new retirees after this date.
• Simplified Benefits Administration: The shift to MedigapFreedom aims to streamline benefits and ensure compliance with updated legal requirements, making it easier for organizations and retirees to manage coverage.

When comparing the Medigap and Medicare Advantage plans Connecticut mostly offers, consider the following factors:

Medigap (Medicare Supplement)

• Provider Choice: Any provider accepting Medicare
• Out-of-Pocket Costs: Predictable, standardized
• Prescription Drug Coverage: Not included (add Part D separately)
• Extra Benefits: Limited
• Plan Changes in 2026: Must enroll in MedigapFreedom plans
• Enrollment Flexibility: More flexible outside Open Enrollment

Medicare Advantage Plans Connecticut

• Provider Choice: Network-based (may require referrals)
• Out-of-Pocket Costs: Lower premiums, but higher out-of-pocket costs
• Prescription Drug Coverage: Often included
• Extra Benefits: May include dental, vision, hearing
• Plan Changes in 2026: Some plans exiting, new benefits added
• Enrollment Flexibility: Annual enrollment periods

Tips for Choosing Wisely

• Review Your Current Coverage: If your Medicare Advantage plan is being discontinued, compare new plan options early to avoid gaps in coverage.
• Assess Your Healthcare Needs: Consider your preferred doctors, prescription needs, and whether you value extra benefits like dental or vision.
• Budget for Costs: Medigap offers more predictable costs, while Medicare Advantage may have lower premiums but higher out-of-pocket expenses.
• Check Provider Networks: Ensure your preferred providers are in-network for Medicare Advantage plans in Connecticut.
• Consult a Local Expert: Regulations and plan availability can vary by state. CT Insurance Agency can help you navigate these changes and select the best plan for your needs.

The 2026 updates to Medigap and Medicare Advantage plans in Connecticut bring both new opportunities and important decisions. By understanding the latest changes and evaluating your personal healthcare needs, you can make a confident, informed choice for your retirement health coverage.

For personalized guidance on Medicare Advantage plans in Connecticut or transitioning to the new MedigapFreedom products, contact CT Insurance Agency today.