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What retirees should know during Medicare Open Enrollment season

It pays to compare your current plan with other options

Updated:

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By:
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Mark Huffman
Reporter

Mark Huffman has covered consumer issues since 2004, with a special focus on protecting and empowering older adults. A former news correspondent for the Associated Press Radio Network, Westwood One, and ConsumerAffairs, Mark brings decades of journalistic experience to RetirementLiving.com. He is passionate about giving consumers a voice and helping them make informed decisions. Mark has also created educational content, including Senior Scam Alert, a video resource designed to help seniors recognize and avoid fraud. He holds a B.A. from the University of Kentucky and lives with his family in Richmond, Virginia.
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Key Insights

  • Review your coverage: Don’t automatically renew — costs and benefits can change each year.
  • Compare total costs: Premiums are just one piece; consider deductibles, copays, and out-of-pocket limits.
  • Check provider networks and prescriptions: Ensure your doctors and medications are still covered.

Medicare’s annual open enrollment period runs from through December 7. During this time, retirees can switch between Original Medicare and Medicare Advantage plans, change Part D prescription drug coverage, or update an existing plan. Any changes you make take effect on January 1 of the following year.

Step 1: Assess your current plan

Start by reviewing how your current plan performed this year. Did you have unexpected costs? Were your preferred doctors or pharmacies covered? Did your prescriptions change? Most plans send an Annual Notice of Change (ANOC) in September — read it carefully to see if premiums, benefits, or provider networks are changing.

Step 2: Compare all costs, not just premiums

A low monthly premium doesn’t always mean a better deal. Look at:

  • Deductibles and copays: How much you’ll pay before coverage kicks in.
  • Maximum out-of-pocket limits: This cap can protect you if you face serious illness or high medical expenses.
  • Prescription drug costs: Check your medications in each plan’s formulary — prices can vary widely between plans.

Medicare’s Plan Finder tool at Medicare.gov allows you to compare plans side by side, factoring in your prescriptions, location, and pharmacy preferences.

Step 3: Check provider networks

If you’re considering a Medicare Advantage (Part C) plan, make sure your preferred doctors, hospitals, and specialists are in-network. Out-of-network care can cost significantly more — or may not be covered at all. 

For retirees who travel frequently or live part of the year in another state, Original Medicare plus a Medigap policy may provide more flexibility.

Step 4: Evaluate extra benefits

Many Medicare Advantage plans now include extras such as vision, dental, hearing, fitness memberships, and transportation services. These perks can add value but shouldn’t be the deciding factor if the plan’s core medical coverage or network doesn’t meet your needs.

Step 5: Seek help if needed

If you find the process confusing, reach out for free guidance from your State Health Insurance Assistance Program (SHIP) or a licensed Medicare counselor. Avoid high-pressure sales tactics and always verify that any advisor is independent and unbiased.

Open enrollment is your once-a-year opportunity to make sure your coverage fits your health and budget. Taking the time to compare options — even if you’re satisfied with your current plan — can prevent costly surprises in the year ahead.