Here's a quick, practical guide to HAP Medicare Advantage plans for 2026. We'll cover what's new this year, who can apply, how to compare policies, and how to sign up or switch plans whether you're in Ireland or the US. You'll find exact dates, costs in euros and dollars, links to official websites, and step-by-step instructions to help you enroll or switch plans confidently.

Quick reference

- Medicare Part B standard premium in 2026: US$202.90 (approx. €189 using US$1 = €0.93). Annual Part B deductible: US$283 (approx. €263). Effective 1 Jan 2026: faster prior‑authorisation rules apply for certain services.

- Open Enrollment for 2026 (Annual Election Period, AEP) ran 15 Oct–7 Dec 2025; next AEP starts 15 Oct 2026 for 2027 plans. Medicare Advantage Open Enrollment Period (to switch MA plans) runs 1 Jan–31 Mar each year.

- Typical HAP MA plan features to check: monthly premium (many plans have US$0 premium but some charge extra), maximum out‑of‑pocket (MOOP) limits (plans commonly list MOOPs in the range of about US$3,000–US$8,000 depending on benefits), drug tiers and formularies, prior authorisation rules, and in‑network provider lists.

Mastheads

- Key official pages and tools: Medicare Plan Finder: https://www.medicare.gov/plan-compare; HAP main site: https://www.hap.org/; CMS (Centre for Medicare & Medicaid Services): https://www.cms.gov/; Social Security: https://www.ssa.gov/; Irish Dept. Of Foreign Affairs guidance: https://www.gov.ie/en/organisation/department-of-foreign-affairs/.

- Medicare helpline: 1‑800‑MEDICARE (1‑800‑633‑4227). For pre‑enrolment questions contact HAP via https://www.hap.org/ and use the Medicare/Medicaid section to find local phone numbers and plan brochures.

Introduction

Honestly, medicare Advantage (MA) plans — also called Part C — bundle Part A (hospital) and Part B (medical) and usually Part D (prescription) into a single plan run by private insurers. HAP (Health Alliance Plan of Michigan) offers MA plans in specific Michigan counties and nearby service areas. For 2026 some administrative rules tightened: prior‑authorisation timelines and documentation standards were updated from 1 January, and there were modest price shifts across Medicare premiums and deductibles.

But the fundamentals are the same: HAP plan choice matters because network, drug coverage and MOOP shape your out‑of‑pocket risk. This guide walks through who’s eligible, the exact enrolment windows, how to compare plans using online tools, and step‑by‑step enrolment or switching procedures — including how Irish residents and dual nationals should prepare when moving to the US or maintaining US coverage while abroad.

Prerequisites

Before you begin, make sure you have all the necessary documents and know the correct dates. Missing these can cause delays.

  • Medicare Part A and Part B enrolment. Part A is usually premium‑free for those with enough US work credits; Part B carries the 2026 standard premium of US$202.90. If you're approaching age 65, plan your Initial Enrollment Period (IEP): it runs for seven months — the three months before your 65th birthday month, the month you turn 65, and the three months after.
  • Registered US mailing address in the HAP service area. HAP requires you to live in the plan’s service area to join. If you’re abroad temporarily but intend to return, you'll still need a US residential address on file.
  • Social Security Number (SSN) and proof of identity. You’ll need these to enrol via Social Security or to verify eligibility on Medicare.gov.
  • List of current medications (with dosages), preferred doctors and hospitals, and copies of recent medical records if you expect prior authorisation issues. You can use the Medicare Plan Finder to input your medications and doctors to get an estimate of your costs.
  • Irish citizens in Ireland thinking about moving to the US should reach out to the Department of Foreign Affairs and the US Embassy in Dublin for advice on visas, moving, and Social Security questions. Also check Social Security’s international pages: https://www.ssa.gov/foreign/.

Step‑by‑step: How to compare HAP plans for 2026

  1. Start at Medicare Plan Finder. Go to https://www.medicare.gov/plan-compare and enter a US ZIP code in the HAP service area. If you're checking from Ireland, use the ZIP code where you'll receive mail in the US — Medicare’s tool uses ZIP to show available plans.
  2. Enter medications and doctors. Click the drug and providers tab. Type each medication, dose and frequency, and add primary care clinicians and specialists you use. The tool runs cost comparisons including estimated annual drug costs and copays for office visits.
  3. Filter for HAP plans. Use the insurer filter to show only HAP plans. Compare monthly premiums, MOOP, primary care copays, and whether Part D prescription is included. Note any extra benefits such as dental, vision, hearing or over‑the‑counter allowances — HAP often lists those in plan brochures.
  4. Check formularies and pharmacy network. Open the plan's detailed brochure (Evidence of Coverage and Formulary documents) and confirm your regular drugs are covered at reasonable tier levels. Look up local pharmacies in the HAP network; out‑of‑network pharmacy fills can be costly.
  5. Compare prior authorisation rules and appeals. Since 1 Jan 2026 faster prior‑authorisation timelines came in, but plans still differ on which services require approval. The Evidence of Coverage lists prior‑authorisation and step therapy policies. If you need regular procedures, ensure the prior‑auth pathway is straightforward.
  6. Check star ratings and quality metrics. Medicare gives plans a star rating (1–5). Higher stars usually mean better care metrics and customer satisfaction. You’ll find ratings on the Plan Finder and HAP plan pages.
  7. Run total‑cost estimates. Don’t just look at the premium. Add expected copays, deductible, drug costs and potential MOOP exposure. Medicare Plan Finder shows estimated yearly costs — use it to compare real‑world totals.

Step‑by‑step: How to enrol or switch (from Ireland or within US)

  1. If you’re new to Medicare: Apply for Part A and Part B via Social Security. Online applications are at https://www.ssa.gov/ — use My Social Security (https://www.ssa.gov/myaccount/) to start. You can apply up to three months before your 65th birthday month. If living abroad, check international procedures at https://www.ssa.gov/foreign/ and contact the US Embassy in Dublin for guidance.
  2. If you already have Part A and B: Enrol in a HAP MA plan during AEP (15 Oct–7 Dec) for coverage starting 1 Jan. If you miss AEP, you can switch plans during MA Open Enrollment (1 Jan–31 Mar) for a one‑time change.
  3. Enrol online or by phone. From Ireland use Medicare Plan Finder enrolment links or go to HAP’s site https://www.hap.org/ to find online application forms and plan phone numbers. You’ll need your Medicare card details, SSN and US mailing address. If enrolling by phone, call Medicare at 1‑800‑633‑4227 for guidance or the HAP Medicare number listed on their site.
  4. Mail or electronic signature. Some plans require a paper enrolment with a signatures page mailed to a US address. If you’re abroad, arrange for a trusted US contact to receive and forward documents or use HAP’s electronic enrolment options where available.
  5. Confirm effective date and ID card. After enrolment HAP will send a member ID card and plan welcome packet. Confirm when coverage starts (usually 1 Jan after AEP). Keep your Medicare card — you still need it for Original Medicare questions and for proof of Part B enrolment.
  6. If switching plans mid‑year. Use the MA Open Enrollment Period (1 Jan–31 Mar) to change once. You can also qualify for Special Enrollment Periods (SEPs) for life events — moving into a plan area, losing employer coverage, or changes in dual‑eligibility status. Document the event and contact Medicare or HAP to trigger an SEP.

Tips

  • Save PDFs of Evidence of Coverage and formularies for each HAP plan you consider. These contain exact copays, MOOP and prior‑auth rules.
  • If you take specialty drugs, check specialty pharmacy rules — some plans require specialty fills from particular pharmacies that might not ship internationally.
  • Keep a US mailing address and a nominated local contact if you live in Ireland but will be enrolling from abroad. Some confirmations and welcome packs arrive by mail and require action within set timelines.
  • Ask HAP about telehealth and out‑of‑area emergency coverage. Many MA plans include telemedicine and worldwide emergency care rules — useful if you travel between Ireland and the US.
  • Use the Medicare helpline 1‑800‑633‑4227 for language help and to verify plan effective dates and enrolment receipts if you can’t reach HAP directly from overseas.

Common mistakes to avoid

  • Assuming a US$0 premium means low cost. Zero premium plans can still have high copays or narrow networks that push costs up fast.
  • Not checking the drug formulary for 2026. Formularies change annually — a drug covered in 2025 may move tiers or require prior authorisation in 2026.
  • Forgetting the service area requirement. Enrolling in a HAP plan while living outside its service area can lead to denial of claims — confirm your US residential ZIP is within HAP’s coverage map.
  • Missing deadlines. AEP and MA Open Enrollment dates are strict. If you miss AEP you may have limited options until the next window unless you qualify for an SEP.
  • Assuming Medicare covers long‑term care. It generally doesn’t. MA plan benefits vary for custodial care, so check HAP’s supplemental services carefully.

Related Articles

HAP’s 2026 Medicare Advantage plans sit alongside new prior‑authorisation rules and modest cost shifts — check the US$202.90 Part B premium and the US$283 Part B deductible, compare formularies and MOOPs carefully, and use Medicare Plan Finder plus HAP’s Evidence of Coverage to lock in the plan that fits your health and travel habits.

This article was created with AI assistance.