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State Health Plan Votes to Raise Medicare Advantage Costs

Jun 05, 2026

The State Health Plan Board of Trustees voted Friday to raise costs for members enrolled in the Humana Medicare Advantage plans — and SEANC is pushing back.

The board's vote was unanimous. The changes take effect in 2027 and affect nearly 177,000 Medicare retirees currently enrolled in the Humana plans.

What you'll pay starting in 2027

Copays and out-of-pocket costs are going up across the board:

  • Medical out-of-pocket maximum: $4,000 → $4,500 (Base); $3,300 → $3,700 (Enhanced)
  • Inpatient hospital stay: $160 → $200 per day (Base); $125 → $150 per day (Enhanced)
  • Specialist visit: $40 → $50 (Base); $35 → $45 (Enhanced)
  • Advanced imaging: $100 → $175 (Base); $100 → $150 (Enhanced)
  • Radiology: $40 → $75 (Base); $40 → $50 (Enhanced)
  • Part B drugs: $0 → $50 on both plans
  • Tier 1 prescription drugs: $10 → $15 (Base only)

SEANC's position

SEANC Government Relations Director Suzanne Beasley was at Friday's meeting and made clear where we stand.

"These increases are going to turn our folks on their head," Beasley said. "They do live on a fixed income. There's been no increase [in pension payouts]. Their buying power is down, I believe, about 30%. So this is going to be pretty unbearable."

The legislature has failed to approve cost-of-living raises to pensions for years, and now retirees face hundreds of dollars more per year in health insurance costs on top of that. The financial squeeze on state retirees is real, and SEANC will continue fighting for relief on both fronts.

What comes next

The board meets again on July 10 to vote on proposed benefit changes and 2027 premium rates for the more than 500,000 active employees and non-Medicare members on the Standard and Plus plans. Additional cost increases are expected to be on the table at that meeting.

SEANC will be there. We'll keep you informed as decisions are made that affect your coverage and your wallet.