Medicare isn't going anywhere. Honestly, the idea that it’s just going to vanish overnight is one of those political ghost stories that gets dusted off every election cycle. But that doesn't mean things aren't changing. They are. Fast.
If you’re looking for a simple "yes" or "no" on whether President Trump will get rid of Medicare, the answer is a flat no. He’s said it a thousand times: he wants to protect it. However, "protecting" it looks very different depending on who you ask. In early 2026, the reality is a mix of rising monthly costs, a massive push toward private "Medicare Advantage" plans, and some pretty wild new programs for things like weight-loss drugs.
The system is being overhauled, not erased.
The 2026 Price Tag: Why Your Premium Just Jumped
You probably noticed the hit to your Social Security check this January. It stung.
The Trump administration recently announced that the standard Part B premium is jumping to $202.90 per month for 2026. That is a significant 9.7% increase from 2025. For the first time ever, the monthly "standard" premium has crossed that $200 threshold.
Why is this happening? CMS (the Centers for Medicare & Medicaid Services) points to rising healthcare costs and "utilization increases." Basically, people are using more healthcare, and it costs more to provide. Interestingly, the administration claims they actually saved you money here. They made some aggressive cuts to spending on "skin substitutes" in the 2026 Physician Fee Schedule, which they say prevented the premium from going up another $11 a month.
Still, for most seniors, the 2.8% Social Security cost-of-living adjustment (COLA) is getting swallowed up. About a third of that raise is going straight back to the government to pay for Medicare. It’s a net cut in spending power, and it’s hitting low-income retirees the hardest.
TrumpRx and the $50 Ozempic Deal
Here is where it gets interesting. While premiums are up, the administration is trying to balance the scales with something called TrumpRx.
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Starting in late January 2026, this new portal is supposed to link you directly to manufacturers to get "most-favored-nation" pricing. The biggest headline? Weight-loss drugs. If you’ve been trying to get Wegovy, Zepbound, or Ozempic, you know they’ve been nearly impossible to afford on Medicare.
Under a new deal with Eli Lilly and Novo Nordisk, certain Medicare Part D enrollees can now get these GLP-1 drugs for $50 a month.
There are strings attached, of course:
- You need a BMI over 35 to qualify automatically.
- If your BMI is 27-30, you need a "comorbid" condition like heart disease or chronic kidney disease.
- These purchases through TrumpRx don’t count toward your Part D out-of-pocket limit.
It’s a "bridge" program. The government is basically trying to lower the temperature on drug prices by using the bully pulpit rather than just standard legislation.
The Great Healthcare Plan: A Shift to Private Options
Early in January 2026, the White House rolled out "The Great Healthcare Plan." This is the administration's big vision for the future. It’s not about ending Medicare; it’s about changing how the money flows.
The core idea is to stop sending billions in subsidies directly to big insurance companies and instead send that money to you. The goal is to let individuals "buy the health insurance of their choice."
If you’re on Original Medicare (the government-run part), you might not feel this immediately. But if you’re one of the 30+ million people in a Medicare Advantage plan, the ground is shifting. The administration is pushing for more "price transparency." They want every doctor and hospital that accepts Medicare to post their prices clearly in "plain English."
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Secretary of Health and Human Services Robert F. Kennedy Jr. has been vocal about this. He’s pushing for a system where you know the cost before you get the bill. It sounds great in theory, but critics worry that the push toward private "choice" is a slow-motion way of privatizing the whole system.
What About the "Insolvency" Scare?
You’ve probably heard the warnings: Medicare is going bankrupt! It’s a scary headline, but "insolvent" doesn't mean "gone." It means the Part A trust fund (which pays for hospital stays) won't have enough money to cover 100% of its bills. For years, the date was 2028 or 2030. Some 2026 projections suggest we’re hitting that wall sooner than expected.
If the trust fund hits zero, Medicare can still pay out about 90% of its obligations using incoming payroll taxes. It wouldn't stop functioning; it would just have a massive budget gap. To fix this, the Trump administration and Congress are looking at a few "levers":
- Site-Neutral Payments: Paying the same price for a procedure whether it happens in a big hospital or a small doctor's office.
- Medicare Advantage Overpayments: Cutting back on the extra money the government gives private insurers.
- Fraud Prevention: Dr. Mehmet Oz, the new CMS Administrator, has made "eliminating waste" his primary focus for 2026.
Is My Coverage Safe?
For the average person, the answer is yes. Your doctor won't suddenly stop taking Medicare tomorrow.
However, there are "quiet" changes happening that you need to watch. For example, the administration has delayed some rules that would have made it easier for low-income seniors to sign up for Medicare Savings Programs. They’ve also tightened up eligibility for certain "extra benefits" in Medicare Advantage plans—those "free" gym memberships or dental perks might be harder to find in 2027.
There is also a significant push for Work Requirements in Medicaid, which is a different program but often overlaps for "dual-eligible" seniors. While Medicare itself doesn't have work requirements, the administration's broader philosophy is that government aid should be a "hand up, not a handout."
What You Should Do Right Now
Since the system is in flux, being passive is the worst thing you can do. The days of "set it and forget it" Medicare are over.
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Check your Part B Premium. If you are a high-earner, the IRMAA (Income-Related Monthly Adjustment Amount) brackets have shifted. You might be paying way more than the $202.90 base rate.
Explore TrumpRx. If you’re on expensive name-brand drugs, go to the portal and see if your medication is listed. The $50 weight-loss drug deal is a massive win for those who qualify, but you have to jump through the hoops to get it.
Watch the "Great Healthcare Plan" debates. If Congress codifies this plan, your Medicare Advantage options could change drastically by 2027. We’re talking about "Health Savings Accounts" for seniors—a concept that was unheard of a few years ago.
Verify your doctor's status. With the new price transparency rules, some smaller practices are complaining about the paperwork. Make sure your preferred specialists are still "in-network" for your 2026 plan.
Medicare is evolving into a more market-driven, private-leaning system. It isn't being abolished, but it is being redesigned. Keeping your eyes on the fine print is the only way to make sure your retirement stays on track.
To stay ahead of these changes, you should review your Annual Notice of Change (ANOC) immediately if you haven't already, as many of the 2026 premium hikes and coverage adjustments are already being reflected in current billing cycles.