Every fall, a familiar season arrives. Yes, pumpkin spice. Yes, football. But I’m talking about the always-riveting Medicare Open Enrollment Period.

From October 15 through December 7, 2026, Medicare beneficiaries have an opportunity to review their coverage and make certain changes for the upcoming year. And while you may be perfectly happy with your current plan, spending a little time reviewing your options could help you avoid an unpleasant surprise in 2027.

 

 

What Can You Change During Open Enrollment?

During the Annual Enrollment Period, you can:

• Switch from Original Medicare to Medicare Advantage, or vice versa.
• Switch from one Medicare Advantage plan to another.
• Join, drop, or switch a Medicare Part D prescription drug plan.

Changes made during this period generally take effect January 1, 2027. If your current coverage still meets your needs, you don't have to make a change. But don't assume that because your plan worked well this year, it will be the best fit next year.

 

 

A Few Numbers Worth Knowing for 2026

Medicare costs and benefits change from year to year, and 2026 brought some notable updates. The standard Medicare Part B premium is $202.90 per month in 2026, up from $185 in 2025. The annual Part B deductible also increased from $257 to $283. Higher-income beneficiaries may pay more because of Medicare's income-related adjustments.

Prescription drug coverage also received another major update. The Part D annual out-of-pocket threshold is $2,100 in 2026, compared with $2,000 in 2025. Once you reach that threshold for covered Part D drugs, you generally won't have additional out-of-pocket costs for covered Part D prescriptions for the remainder of the year. And for the first time, Medicare's negotiated prices for 10 high-cost prescription drugs took effect January 1, 2026. The negotiated prices apply to certain Part D drugs and are intended to lower costs for eligible beneficiaries taking those medications.

 

 

Original Medicare vs. Medicare Advantage vs. Medigap

Original Medicare: Includes Part A for hospital coverage and Part B for medical services. It generally doesn't include prescription drug coverage, routine dental or vision coverage, or an annual out-of-pocket maximum for Parts A and B.

Medicare Advantage (Part C): Offered by private insurers and combines Part A and Part B coverage. Many plans also include prescription drug coverage and additional benefits such as dental, vision, hearing, or fitness programs.

Medicare Supplement (Medigap): Works alongside Original Medicare to help cover certain deductibles, coinsurance, and copayments.

One important distinction: the October 15–December 7 Annual Enrollment Period primarily applies to Medicare Advantage and Part D decisions. Medigap has its own enrollment rules, and switching Medigap policies later can involve medical underwriting depending on your circumstances.

 

 

Questions to Ask Before Changing Plans

If you're considering Medicare Advantage, ask:

• Are my doctors, specialists, and preferred hospitals in the plan's network?
• Are all of my prescriptions covered, and what will they cost?
• What is the plan's annual out-of-pocket maximum?
• Have the premiums, deductibles, copays, or coinsurance changed?
• Do the plan's dental, vision, hearing, or other benefits actually matter to me?
• Will this plan work if I spend part of the year traveling or living somewhere else?

If you're reviewing Part D coverage, don't just compare the monthly premium. Check the actual medications you take. A plan with a slightly higher premium could potentially save you money if it offers better coverage for your prescriptions. Also, if you have significant prescription costs, look into the Medicare Prescription Payment Plan. Part D plans are required to offer beneficiaries the option to spread covered prescription out-of-pocket costs across monthly payments instead of paying the full amount at the pharmacy.

 

 

Don't Skip Your Annual Notice of Change

Your Annual Notice of Change (ANOC) is one of the most important pieces of mail you'll receive this fall. Your plan sends this document each September, and it outlines changes to your premiums, benefits, costs, and coverage that will take effect in January. Before deciding to stay with your current plan, take a few minutes to review:

Your doctors + Your prescriptions + Your premiums + Your out-of-pocket costs

If any of those four things have changed, it's worth taking a closer look.

 

 

A Few Tips for a Less Stressful Enrollment Season

 

Don't wait until December 7. Giving yourself time to compare options is much less stressful than trying to make a decision at the last minute.

Don't shop based on premium alone. A low monthly premium doesn't necessarily mean the plan will cost less overall.

Use trustworthy resources. Medicare.gov and your State Health Insurance Assistance Program (SHIP) offer free information and counseling.

And don't be afraid to ask questions. Medicare can be complicated, and the right choice depends on your health needs, prescriptions, budget, and lifestyle.

 

 

The Bottom Line

Medicare doesn't need to feel like a maze. You don't have to change your coverage every year, but you should know what you're paying for and what you're getting in return.

Think of Medicare Open Enrollment as your annual financial checkup for healthcare. Spend a little time reviewing your coverage now, and you may save yourself money, frustration, or an unpleasant surprise next year.

 

 

Audience FAQs

 

Do I have to change my Medicare plan during Open Enrollment?

No. If you're happy with your current coverage, you can generally keep it. However, reviewing your Annual Notice of Change is important because premiums, networks, drug formularies, and benefits can change from year to year.

 

Can I switch from Medicare Advantage back to Original Medicare?

Yes. You can do so during the Annual Enrollment Period. There is also a separate Medicare Advantage Open Enrollment Period from January 1 through March 31, during which someone enrolled in Medicare Advantage can switch to another Medicare Advantage plan or return to Original Medicare.

 

What happens if I miss December 7?

Generally, you'll remain in your current coverage for the following year unless you qualify for a Special Enrollment Period or another enrollment opportunity.

 

Do I need Part D if I don't take prescription medications?

Going without creditable prescription drug coverage for 63 or more days after you're eligible can result in a late-enrollment penalty if you enroll in Part D later. Your individual circumstances matter, so it's worth understanding your options before declining coverage.

 

Where can I get help comparing Medicare plans?

Medicare.gov is a good place to start, and your State Health Insurance Assistance Program (SHIP) provides free, personalized Medicare counseling. You can also work with a qualified Medicare insurance professional who can help you compare available plans.

 

Warm Regards, 

Chandler