Medicare changes ahead for Iowans as open enrollment begins

With the Medicare open enrollment period underway through Dec. 7, thousands of Iowans are reviewing their options amid significant changes.

According to the Iowa Insurance Division's Senior Health Insurance Information Program, major adjustments in plan offerings, drug coverage and provider networks are expected in 2026 after new federal drug pricing reforms and the 2025 cap on prescription co-payments.

The federal health insurance program provides coverage for people 65 or older, as well as younger people with certain disabilities or health conditions.

Among the biggest changes this year:

Plan cancellations: UnitedHealthcare is canceling eight of its 10 AARP Medicare Advantage plans in Iowa, affecting about 36,500 enrollees. Wellmark is ending three of four plans with drug coverage. Beneficiaries in canceled plans must select a new plan by Jan. 1 to avoid losing coverage.Reduced service areas: 22 other Medicare Advantage plans have shrunk their geographic coverage, meaning some Iowans' plans may no longer be available in their county.Provider network changes: Several large health systems have adjusted which Medicare Advantage plans they accept, making it critical for members to confirm their providers remain in-network.Lower drug costs: Negotiated price reductions are taking effect for 10 high-cost drugs — Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara and Novolog/Fiasp — though costs will vary by plan.

Kristin Griffith, SHIIP and Senior Medicare Patrol director, urged Iowans to act quickly if their plan is ending or no longer offered in their area. Beneficiaries in those situations have guaranteed issue rights, allowing them to switch to another Medicare Advantage plan or return to Original Medicare and buy a Medicare supplement without medical underwriting or higher premiums — but only until Feb. 28.

"It is time individuals on Medicare to read all mail from their plan or provider and stay informed of possible changes," the Iowa Insurance Division said in a news release.

If a Medicare beneficiary receives notice that their plan has been canceled or is no longer offered in their ZIP code, "that letter is the proof required to secure the guaranteed issue right to enroll in a Medicare Supplement," according to the Insurance Division.

Last year, SHIIP-SMP helped more than 52,000 Iowans and saved clients tens of millions of dollars, according to the Insurance Division. Appointments are available statewide but are filling quickly.

Beneficiaries can compare 2026 plans online at Medicare.gov/plan-compare or call 1-800-MEDICARE (633-4227) for 24/7 assistance. For local help, contact SHIIP-SMP at 1-800-351-4664 or visit shiip.iowa.gov for resources and counselor locations.