2026 Medicare Changes in Oklahoma

Important information about plan exits, prescription drug changes, and benefit reductions affecting Medicare beneficiaries

Schedule Free Consultation Call (405) 254-0912
Act NOW!
Expert Guidance Available
Free Plan Comparison

What's Changing in 2026

Major changes are coming to Medicare plans across Oklahoma

Critical Changes You Need to Know

The 2026 plan year brings significant changes to Medicare plan coverage in Oklahoma. Carriers are discontinuing prescription drug plans, and many plans are having their benefits reduced and CoPays increased. If you're currently enrolled in a Medicare Advantage or Part D plan, these changes could directly impact your coverage, out-of-pocket costs, and access to healthcare services.

Medicare Advantage Plan Changes and Exits

Major carriers are discontinuing some Medicare Advantage plans in select Oklahoma counties, leaving some beneficiaries scrambling for new coverage. To find out if your plan is changing or leaving, call us or schedule an appointment. We'll go over all the changes in your county and find the right plan for you.

Prescription Drug Plan Changes

Multiple standalone Part D prescription drug plans are either being discontinued or changed, requiring affected members to review their coverage. See the below section on Prescription Drug changes that may directly impact you.

Widespread Benefit Reductions

Even continuing plans are reducing benefits, increasing premiums, and raising out-of-pocket maximums for 2026. See below for details.

Medicare Advantage Plan Changes in Oklahoma

The year 2026 is bringing the MOST market disruption we've ever seen, going all the way back to the introduction of Medicare Advantage plans in 1997. Some plans are leaving and others are receiving major changes to benefits and Prescription Drug coverages.


Oklahoma Medicare Advantage Plan Changes

Major Changes to PPO Plans:

  • Hospital CoPays are generally increasing - in some cases dramatically - for 2026, prompting the need for additional coverage options
  • Dental coverage is being changed across PPO plans, including reduced benefits and higher out-of-pocket costs
  • We're seeing benefit reductions to vision, hearing, OTC allowances, and more across many PPO plans.
  • Doctor CoPays, outpatient tests and surgeries, and emergency room visits are also increasing on many plans
  • Every Oklahoma PPO Medicare Plan is effected by Presciption Drug changes coming in 2026.

If you are on a Medicare PPO: It is HIGHLY RECOMMENDED that you contact us to review your coverage options for 2026. We'll make sure your access to healthcare is not disrupted and your out-of-pocket costs are as low as possible in 2026.



Some plans are leaving Oklahoma in 2026

If your plan is leaving:

  • You must choose a new Medicare Advantage plan during annual enrollment (Oct. 15th - Dec. 7th)
  • If you don't, the insurance company MAY "cross-walk" you into a different ("similar") plan automatically
  • If no cross-walk plan is available, you'll be returned to Original Medicare
  • Your doctors and prescriptions may not be covered under the cross-walked plans
  • Regardless, your out-of-pocket costs will likely change significantly

Action Required: Don't wait until you receive your cancellation notice. Contact Donaldson Insurance today to review available 2026 options and ensure continuous coverage. We'll help you compare plans, verify your doctors are in-network, and check prescription drug coverage before you enroll.

Prescription Drug Plan Changes

Part D standalone plans being eliminated in 2026

SilverScript Part D Plan Leaving Oklahoma

SilverScript is leaving Oklahoma. If you're currently enrolled in a SilverScript Part D prescription drug plan, you'll need to choose a new plan during the Annual Enrollment Period (October 15 - December 7, 2025). Don't wait until the last minute—contact us today to explore your options and find a plan that covers your medications at the best price.

Standalone Part D Changes

  • The maximum deductible for a Part D plan will be $615, up from $590 in 2025.
  • The out-of-pocket spending cap will be set at $2,100. This is an increase from the $2,000 cap in 2025.
  • The Medicare Prescription Payment Plan will have automatic renewals for enrollees unless they opt out.
  • A major carrier is leaving Oklahoma. Others are changing and consolidating plans.

What You Should Do

Now is the time to review your options and make informed decisions about your 2026 coverage.

  • Review your current medications
  • Compare 2026 Part D plan costs
  • Check preferred pharmacy networks
  • Verify formulary coverage
  • Consider Medicare Advantage alternatives
Get A Free Plan Review

Frequently Asked Questions About 2026 Changes

Get answers to common questions about Medicare changes

When can I change my Medicare plan?

The Annual Enrollment Period runs from October 15 through December 7, 2025. This is when you can switch Medicare Advantage plans, change Part D prescription drug plans, or move between Original Medicare and Medicare Advantage. Changes made during this period take effect January 1, 2026.

What happens if I don't choose a new plan?

If your current plan is being discontinued and you don't select a new plan, you'll be automatically disenrolled and returned to Original Medicare. However, you may lose prescription drug coverage unless you actively enroll in a Part D plan. It's critical to choose a new plan during the enrollment period to avoid gaps in coverage.

How do I know if my plan is affected?

Insurance companies are required to notify affected members by mail. However, don't wait for a notice. Contact Donaldson Insurance now to review your current plan's status and compare 2026 options. We have access to all plan changes and can help you make an informed decision before the enrollment period begins.

Will my doctors still be covered?

Provider networks change every year. Even if your plan is continuing, your doctors may not remain in-network for 2026. When you work with Donaldson Insurance, we verify that your preferred doctors, specialists, and hospitals are in-network before you enroll in a new plan.

Can Donaldson Insurance help me find the right plan?

Absolutely! We specialize in helping Medicare beneficiaries navigate plan changes and find the best coverage for their needs and budget. Our service is completely free—we're paid by the insurance carriers, not by you. We'll review your medications, doctors, healthcare needs, and budget to recommend the most suitable plans for 2026.

Don't Navigate These Changes Alone

Get expert guidance from Donaldson Insurance. We'll help you understand your options, compare plans, and enroll in the best coverage for your needs—at no cost to you.

Schedule Appointment OR Call (405) 254-0912

Why Choose Donaldson Insurance

Expert Medicare guidance during these critical changes

Medicare consultation with insurance expert

Your Trusted Medicare Partner

With extensive experience helping Oklahoma Medicare beneficiaries, we understand the complexity of plan changes and benefit reductions. We'll guide you through every step of the process to ensure you have the best possible coverage for 2026.

Medicare Specialists

Our team specializes exclusively in Medicare, giving you access to expert knowledge and insights.

No Cost to You

Our services are completely free. We're compensated by insurance carriers, never by our clients.

Comprehensive Comparison

We compare all available plans in your area to find the best match for your healthcare needs and budget.

Get Help With 2026 Medicare Changes

We're here to answer your questions and help you find the right coverage

Call Us

405-254-0912

Mon-Fri: 9am-5pm

Email Us

nate@donaldsoninsurancegroup.com

We respond within 24 hours

Service Area

We service all of Oklahoma City, Edmond, Moore, Norman, Del City, Yukon, Mustang, Piedmont, Midwest City, Choctaw, Harrah, Guthrie, and the surrounding areas

We're happy to serve ALL of Oklahoma and have thousands of satisfied customers all over the state.

We also help folks in Texas, Arkansas, and Missouri!