Medicare Open Enrollment: What seniors should know before making changes

Medicare’s annual open enrollment period begins October 15 and runs through December 7, giving more than 65 million Americans a chance to review their coverage and make changes for 2026.

During this window, beneficiaries can switch between Original Medicare and Medicare Advantage, change prescription drug (Part D) plans, or update Advantage coverage. Experts say failing to review your options can be costly — especially as premiums, drug formularies, and provider networks often change from year to year.

Key Considerations

• Plan costs may change: Premiums, deductibles, and copayments often adjust annually. Even small increases can add up, particularly for those on fixed incomes.
• Drug coverage shifts: Formularies — the lists of covered medications — are updated every year. A plan that covered your prescriptions in 2025 may not do so in 2026.
• Doctor and hospital networks: Medicare Advantage plans contract with specific providers. Seniors who want to keep their doctors need to verify they’re still in-network.
• Extra benefits: Advantage plans may include vision, dental, hearing, or wellness programs. These perks can be valuable but should not outweigh coverage for core medical needs.

Why It Matters

Health needs change with age, and sticking with the same plan year after year can leave seniors paying more than necessary or missing out on critical benefits.

• Financial risks: Switching to a poorly matched plan could mean higher out-of-pocket costs, particularly for those with chronic conditions or costly medications.
• Coverage gaps: Seniors who don’t confirm drug coverage may be surprised at the pharmacy counter.
• Access concerns: Choosing a plan without checking provider networks could mean losing access to trusted doctors.

Consumer Advice

Experts recommend these steps before making any changes:

1. Review your Annual Notice of Change (ANOC): This document, mailed by your plan each fall, outlines changes in costs and coverage for the coming year.
2. Use Medicare’s Plan Finder tool: Available at Medicare.gov, it allows side-by-side comparison of plans in your ZIP code, including drug coverage and estimated annual costs.
3. Consult free counseling: Every state offers help through State Health Insurance Assistance Programs (SHIPs), where trained counselors can walk seniors through their options.
4. Beware of marketing pitches: Seniors are often targeted with ads promising extra benefits. Always confirm details directly through Medicare or a trusted counselor.