Medicare Open Enrollment: A Checklist for Reviewing Your Coverage

Every year, Medicare Open Enrollment runs from October 15 through December 7. During this time, people with Medicare can review their coverage and make changes that take effect on January 1.

Even if you are happy with your plan, it is worth reviewing. Medicare Advantage and Part D plans can change their premiums, deductibles, copays, covered drugs and provider networks from year to year.

What you can do during Open Enrollment

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

If you do nothing and your plan is still available, you will generally stay in the same plan next year.

Step 1: Read your Annual Notice of Change

If you are in a Medicare Advantage or Part D plan, your plan sends an Annual Notice of Change (ANOC) each fall, usually by the end of September. It explains what will change next year, such as premiums, copays and covered drugs. Read it carefully.

Step 2: Review your health needs

Ask yourself:

• Did my health change this year?
• Do I expect any surgeries, new treatments or specialists next year?
• Did I start or stop any prescriptions?
• Did I have trouble getting care or approvals from my plan?

Step 3: Check your doctors and hospitals

If you are in a Medicare Advantage plan, confirm that your doctors, specialists, hospitals and pharmacies will still be in the network next year. Call your doctors' offices directly to ask.

Step 4: Check your prescriptions

Make a list of every drug you take, with dosage and frequency. Check that each one is on your plan's formulary for next year and note any changes in tier, copay or requirements like prior authorization.

Remember that Part D plans have an annual out-of-pocket cap on covered drugs. It is $2,100 for 2026 and is set to rise to $2,400 for 2027, so factor that in when you compare plans for next year.

Step 5: Compare total costs, not just premiums

A plan with a low premium might have higher deductibles or copays. Consider:

• Monthly premium
• Deductibles
• Copays and coinsurance for doctor visits, specialists and hospital stays
• Drug costs
• The plan's maximum out-of-pocket limit (for Medicare Advantage)

Step 6: Compare plans

Use the Medicare Plan Finder at Medicare.gov to compare plans in your area. Enter your drugs and pharmacies for a more accurate cost estimate. You can also call 1-800-MEDICARE.

Step 7: Get free, unbiased help

Your State Health Insurance Assistance Program (SHIP) offers free counseling from trained counselors who do not sell insurance. Find yours at shiphelp.org.

Be cautious with marketing

During Open Enrollment, you may receive many calls, mailers and ads. Keep in mind:

• Medicare will not call you to sell a plan.
• Never give your Medicare number to someone who calls you unexpectedly.
• Ads that use government-sounding names may be from private companies.
• Take time to compare, and do not feel pressured to decide on the spot.

Mark your calendar

• Late September: watch for your Annual Notice of Change.
• October 15: Open Enrollment begins.
• December 7: last day to make changes.
• January 1: new coverage begins.

Terrameritavi is an independent publication and is not affiliated with Medicare or any government agency.