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Major 2026 Medicare Plan Changes: How Kroger Retirees Can Prepare

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Healthcare Provider Update: Healthcare Provider for Kroger Kroger partners with a variety of health insurance providers for its employee healthcare plans, which typically include major insurers such as Anthem Blue Cross Blue Shield, UnitedHealthcare, and others. These partnerships offer comprehensive healthcare coverage options to their employees, ensuring access to a broad network of medical services. Potential Healthcare Cost Increases for Kroger in 2026 As we look ahead to 2026, Kroger employees-along with many others-may face substantial healthcare cost increases as health insurance premiums for Affordable Care Act (ACA) marketplace plans are projected to surge. In some states, premiums could rise by as much as 60%, driven by factors such as the expiration of enhanced federal premium subsidies and escalating medical costs, which are now rising at an alarming rate due to inflation and increased demand for healthcare services. According to analysts, without congressional intervention, the average out-of-pocket premium for ACA enrollees could jump by over 75%, putting financial strain on many families and potentially affecting their access to necessary healthcare services. Click here to learn more

'With sweeping Medicare changes ahead, Kroger employees should start comparing plan options early, carefully reviewing provider networks as well as total annual costs to help maintain long-term health care flexibility and stability.' — Paul Bergeron, a representative of The Retirement Group, a division of Wealth Enhancement.

'Kroger employees navigating the 2026 Medicare changes should take a proactive approach—reviewing their Annual Notice of Change and verifying provider access now to make confident, cost-effective health care decisions.' — Tyson Mavar, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article, we will discuss:

  1. The significant structural and cost-related changes coming to Medicare in 2026.

  2. How Kroger retirees can adjust to fewer plan options and shrinking provider networks.

  3. Practical steps to evaluate new coverage, handle rising premiums, and maintain access to quality care.

Significant Updates to Medicare Plans in 2026: Key Information for Kroger Retirees

As 2026 approaches, Kroger retirees should prepare for one of the most impactful Medicare open-enrollment periods in recent memory. Insurers are narrowing plan choices, removing once-popular benefits, and increasing out-of-pocket exposure, which will force many retirees to rethink their health care coverage and long-term medical cost strategy.

“A new perspective on Medicare coverage is needed as we approach the year,” says Brent Wolf, CFP® of Wealth Enhancement. The coming changes will deeply affect premiums, provider access, and treatment costs—much more than superficial plan tweaks.

Rising Costs, Narrower Margins, and Insurer Pullbacks

The current strain stems from higher utilization, regulatory burdens, and medical inflation. These forces are pushing some insurers to raise coinsurance, deductibles, and out-of-pocket costs in Medicare Advantage plans. Major carriers such as UnitedHealthcare, Aetna, 1  and Elevance Health 2  are restructuring plan designs—often shifting risk toward retirees. For Kroger retirees, grasping these dynamics is critical, since plans that look affordable may incur steep costs during hospital stays or chronic care events.

Careful comparison of the Annual Notice of Change (ANOC) is crucial. This document details cost-tier changes, updated copays, and network revisions. Cross-referencing the ANOC with the Evidence of Coverage and Summary of Benefits can help retirees avoid unpleasant mid-year surprises, such as discovering essential medications have moved into higher cost tiers or that new referral rules for specialists have been adopted.

Shrinking Networks and Transition Planning

The 2026 updates will include both provider-network contractions and plan exits. 3  Insurers are consolidating offerings—with many eliminating preferred provider organizations (PPOs) in favor of health maintenance organizations (HMOs)—to curb costs. This may leave many retirees, including those from companies like Kroger, without access to their preferred doctors or hospitals. Because provider directories are often outdated, retirees should call medical offices directly to confirm that they remain in-network.

For those who prefer maximum flexibility, pairing Original Medicare with a Medigap (supplemental) plan may be an option. But this path can carry higher monthly premiums and underwriting limitations for those who miss their initial Medigap eligibility window. Once the guaranteed-issue period closes, reapplying later may be difficult or costly.

Prescription Drug Coverage Overhaul

Part D prescription coverage will see the most visible changes. The number of standalone Part D plans is expected to fall from 464 in 2025 to about 360 in 2026. 4  Many remaining plans are shifting from fixed copays to percentage-based coinsurance, increasing cost exposure for retirees dependent on high-cost medications. Deductibles are also expected to climb, while out-of-pocket drug costs for covered medications will be capped at $2,100 per year. 5  

These changes make it important to use the Medicare.gov Plan Finder to review every medication before enrolling. The tool compares not only monthly premiums but also total annual drug costs. Retirees who make the right selection or use pharmacy discount programs may consequently reduce their drug spending.

Reduced Ancillary Benefits

To sustain margins, many insurers will trim supplemental benefits previously available under Medicare Advantage, such as life insurance, funeral planning expenses, and certain cosmetic surgeries. 6  These extras were once heavily promoted but will be scaled back in 2026. Wolf suggests retirees distinguish between “essential” and “nice-to-have” benefits when choosing new coverage.

Broker Compensation and Transparency

Some carriers are reducing or eliminating commissions on certain plan types, which could affect broker recommendations. Retirees should remain vigilant and compare any suggestions against the Medicare Plan Finder. Independent organizations like the Medicare Rights Center or SHIP (State Health Insurance Assistance Program) can provide neutral support in evaluating plan options.

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Policy and Cost Adjustments on the Horizon

Several policy-level updates will shape the 2026 Medicare landscape:

  • - The CMS 2026 final rule introduces changes to appeals procedures and standardization requirements.

  • - Government payments to Medicare Advantage plans are expected to increase by about 5.06 % in 2026. 7

  • - Original Medicare will pilot prior authorization in six states—potentially slowing access to some services. 8

  • - The Part B monthly premium is expected to rise by roughly 11.6 %, from $185 to about $206.50 in 2026. 9

  • - By 2034, Part B premiums and deductibles could increase by nearly 188% compared to 2025 levels. 10

  • - Small increases are also expected in Part A deductibles and coinsurance, especially for those lacking sufficient work credits.

Practical Steps for Kroger Retirees

1. Mark Your Calendar:  Open enrollment runs from October 15 to December 7, 2025, with changes effective January 1, 2026.

2. Review All Notices:  Compare your Annual Notice of Change, Summary of Benefits, and Evidence of Coverage.

3. Compare Total Costs:  Use the Medicare.gov Plan Finder to evaluate full annual costs—not only premiums.

4. Verify Providers:  Call hospitals and doctors' offices to confirm network participation in advance.

5. Reassess Medigap Eligibility:  Understand guaranteed-issue rights and underwriting rules in your state.

6. Cross-Check Broker Advice:  Match broker suggestions against Plan Finder data.

7. Seek Neutral Help:  Reach out to the Medicare Rights Center or SHIP for unbiased assistance.

8. Prepare for Premium Increases:  Budget for rising Part B and IRMAA-related costs.

9. Re-evaluate Prescriptions:  Run simulations of alternate plans under coinsurance vs. copay models.

10. Act Early:  Delaying until December may reduce access to support and limit flexibility.

Conclusion

By 2026, Medicare’s landscape will shift: networks will narrow, perks will diminish, and cost exposure will grow. However, Kroger retirees who plan ahead, compare options thoroughly, and seek trusted guidance can still preserve their access to care and manage expenses.

Under upcoming rules, Medicare Advantage providers will need to update CMS with changes to their network directories within 30 days, and confirm directory accuracy annually. Beneficiaries who discover incorrect listings after enrollment may qualify for a Special Enrollment Period to change plans.

Navigating the 2026 Medicare reforms is like steering through changing tides—familiar routes will shift, and preparation is key. With informed choices, Kroger retirees can chart a clearer course toward dependable and cost-efficient health care coverage.

Sources:

How does the KROGER CONSOLIDATED RETIREMENT BENEFIT PLAN ensure that employees receive adequate retirement benefits calculated based on their years of service and compensation? Are there specific formulas or formulas that KROGER uses to ensure fair distribution of benefits among its participants, particularly in regards to early retirement adjustments?

The KROGER CONSOLIDATED RETIREMENT BENEFIT PLAN ensures that employees receive adequate retirement benefits based on a formula that takes into account both years of credited service and compensation. The plan, being a defined benefit plan, calculates benefits that are typically paid out monthly upon reaching the normal retirement age, but adjustments can be made for early retirement. This formula guarantees that employees who retire early will see reductions based on the plan’s terms, ensuring a fair distribution across participants​(KROGER_2023-10-01_QDRO_…).

In what ways does the cash balance formula mentioned in the KROGER CONSOLIDATED RETIREMENT BENEFIT PLAN impact the retirement planning of employees? How are these benefits expressed in more relatable terms similar to a defined contribution plan, and how might this affect an employee's perception of their retirement savings?

The cash balance formula in the KROGER CONSOLIDATED RETIREMENT BENEFIT PLAN impacts retirement planning by expressing benefits in a manner similar to defined contribution plans. Instead of a traditional annuity calculation, the benefits are often framed as a hypothetical account balance or lump sum, which might make it easier for employees to relate their retirement savings to more familiar terms, thereby influencing how they perceive the growth and adequacy of their retirement savings​(KROGER_2023-10-01_QDRO_…).

Can you explain the concept of "shared payment" and "separate interest" as they apply to the KROGER CONSOLIDATED RETIREMENT BENEFIT PLAN? How do these payment structures affect retirees and their alternate payees, and what considerations should participants keep in mind when navigating these options?

In the KROGER CONSOLIDATED RETIREMENT BENEFIT PLAN, "shared payment" refers to a payment structure where the alternate payee receives a portion of the participant’s benefit during the participant's lifetime. In contrast, "separate interest" means that the alternate payee receives a separate benefit, typically over their own lifetime. These structures impact how retirees and their alternate payees manage their retirement income, with shared payments being tied to the participant’s life and separate interests providing independent payments​(KROGER_2023-10-01_QDRO_…).

What procedures does KROGER have in place for employees to access or review the applicable Summary Plan Description? How can understanding this document help employees make more informed decisions regarding their retirement benefits and entitlements under the KROGER plan?

KROGER provides procedures for employees to access the Summary Plan Description, typically through HR or digital platforms. Understanding this document is crucial as it outlines the plan’s specific terms, helping employees make more informed decisions about retirement benefits, including when to retire and how to maximize their benefits under the plan​(KROGER_2023-10-01_QDRO_…).

With regard to early retirement options, what specific features of the KROGER CONSOLIDATED RETIREMENT BENEFIT PLAN can employees take advantage of? How does the plan's definition of "normal retirement age" influence an employee's decision to retire early, and what potential consequences might this have on their benefits?

The KROGER CONSOLIDATED RETIREMENT BENEFIT PLAN offers early retirement options that include adjustments for those retiring before the plan’s defined "normal retirement age." This early retirement can result in reduced benefits, so employees must carefully consider how retiring early will impact their overall retirement income. The definition of normal retirement age serves as a benchmark, influencing the timing of retirement decisions​(KROGER_2023-10-01_QDRO_…).

How does the KROGER CONSOLIDATED RETIREMENT BENEFIT PLAN address potential changes in federal regulations or tax law that may impact retirement plans? In what ways does KROGER communicate these changes to employees, and how can participants stay informed about updates to their retirement benefits?

The KROGER CONSOLIDATED RETIREMENT BENEFIT PLAN incorporates changes in federal regulations or tax laws by updating the plan terms accordingly. KROGER communicates these changes to employees through official channels, such as newsletters or HR communications, ensuring participants are informed and can adjust their retirement planning in line with regulatory changes​(KROGER_2023-10-01_QDRO_…).

What are some common misconceptions regarding participation in the KROGER CONSOLIDATED RETIREMENT BENEFIT PLAN that employees might have? How can these misconceptions impact their retirement planning strategies, and what resources does KROGER provide to clarify these issues?

A common misconception regarding participation in the KROGER CONSOLIDATED RETIREMENT BENEFIT PLAN is that it functions similarly to a defined contribution plan, which it does not. This can lead to confusion about benefit accrual and payouts. KROGER provides resources such as plan summaries and HR support to clarify these misunderstandings and help employees better strategize their retirement plans​(KROGER_2023-10-01_QDRO_…).

How does the KROGER CONSOLIDATED RETIREMENT BENEFIT PLAN interact with other employer-sponsored retirement plans, specifically concerning offsetting benefits? What implications does this have for employees who may also be participating in defined contribution plans?

The KROGER CONSOLIDATED RETIREMENT BENEFIT PLAN interacts with other employer-sponsored retirement plans by offsetting benefits, particularly with defined contribution plans. This means that benefits from the defined benefit plan may be reduced if the employee is also receiving benefits from a defined contribution plan, impacting the total retirement income​(KROGER_2023-10-01_QDRO_…).

What options are available to employees of KROGER regarding the distribution of their retirement benefits upon reaching retirement age? How can employees effectively plan their retirement income to ensure sustainability through their retirement years based on the features of the KROGER plan?

Upon reaching retirement age, KROGER employees have various options for distributing their retirement benefits, including lump sums or annuity payments. Employees should carefully plan their retirement income, considering the sustainability of their benefits through their retirement years. The plan’s features provide flexibility, allowing employees to choose the option that best fits their financial goals​(KROGER_2023-10-01_QDRO_…).

How can employees contact KROGER for more information or assistance regarding the KROGER CONSOLIDATED RETIREMENT BENEFIT PLAN? What are the recommended channels for employees seeking guidance on their retirement benefits, and what type of support can they expect from KROGER's human resources team?

Employees seeking more information or assistance regarding the KROGER CONSOLIDATED RETIREMENT BENEFIT PLAN can contact the company through HR or dedicated plan administrators. The recommended channels include direct communication with HR or online resources. Employees can expect detailed support in understanding their benefits and planning for retirement​(KROGER_2023-10-01_QDRO_…).

With the current political climate we are in it is important to keep up with current news and remain knowledgeable about your benefits.
Kroger offers both a defined benefit pension plan and a 401(k) retirement savings account plan. The defined benefit plan provides retirement income based on years of service and final average pay. The 401(k) plan allows employees to save for retirement with personal and employer contributions, including a company match. Employees can choose from various investment options within the 401(k) plan to grow their retirement savings.
Operational Changes: Kroger is undergoing a restructuring process that includes closing underperforming stores and cutting administrative costs. Layoffs: The company has announced layoffs affecting about 1,500 employees (Source: CNN). Financial Performance: Despite these changes, Kroger reported a 7% increase in same-store sales for Q2 2023, reflecting strong consumer demand (Source: Kroger).
Kroger offers RSUs that vest over time, providing shares to employees upon vesting. Stock options are also available, allowing employees to purchase shares at a set price, potentially benefiting from stock price increases.
Kroger has made significant updates to its employee healthcare benefits to align with the current economic, investment, tax, and political environment. In 2022, Kroger Health, the healthcare division of The Kroger Co., entered into a direct agreement with Prime Therapeutics to ensure continued access to affordable healthcare services for over 33 million Americans. This agreement, effective January 1, 2023, allowed Kroger's pharmacies to remain in-network for Prime's Medicare Part D members and other commercial, Medicare, and Medicaid customers. This initiative underscores Kroger's commitment to providing comprehensive healthcare services, including administering COVID-19 vaccines, offering in-store antibody tests, and distributing at-home COVID-19 tests, thereby enhancing health access and affordability. In 2023, Kroger was recognized for its commitment to workplace mental health, receiving the Gold Bell Seal for Workplace Mental Health from Mental Health America for the second consecutive year. This certification highlights Kroger's efforts to create a supportive and caring environment for its associates, focusing on mental, physical, and financial well-being. Kroger's wellness programs, mental health services, Employee Assistance Programs (EAP), and paid time off were rigorously evaluated, demonstrating the company's ongoing dedication to employee well-being. These efforts are part of Kroger's broader strategy to ensure a healthy and productive workforce, which is critical in navigating the current economic challenges and maintaining long-term business success.
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For more information you can reach the plan administrator for Kroger at 104 vine street Cincinnati, OH 45202-1100; or by calling them at 513-762-4000.

https://www.thekrogerco.com/documents/pension-plan-2022.pdf - Page 5, https://www.thekrogerco.com/documents/pension-plan-2023.pdf - Page 12, https://www.thekrogerco.com/documents/pension-plan-2024.pdf - Page 15, https://www.thekrogerco.com/documents/401k-plan-2022.pdf - Page 8, https://www.thekrogerco.com/documents/401k-plan-2023.pdf - Page 22, https://www.thekrogerco.com/documents/401k-plan-2024.pdf - Page 28, https://www.thekrogerco.com/documents/rsu-plan-2022.pdf - Page 20, https://www.thekrogerco.com/documents/rsu-plan-2023.pdf - Page 14, https://www.thekrogerco.com/documents/rsu-plan-2024.pdf - Page 17, https://www.thekrogerco.com/documents/healthcare-plan-2022.pdf - Page 23

*Please see disclaimer for more information

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