Medicare Open Enrollment runs every Oct. 15 through Dec. 7— and it’s your annual opportunity to change your health care coverage for the coming year. During this period, you can join, switch, or drop Medicare Advantage and Medicare Part D drug plans and switch between original Medicare and Medicare Advantage. Any changes you make typically take effect Jan. 1.
Since Medicare plans can modify their costs, benefits, drug coverage, and provider networks each year, it’s important to explore your options before making a decision. The choices you make during Open Enrollment could save—or cost—you hundreds of dollars out of pocket and even affect your access to care. Below are three ways to ensure you’re well-prepared for Medicare's Open Enrollment Period.
3 Steps to Take During Medicare Open Enrollment
| What to do | What to check | |
|---|---|---|
| 1. Review your ANOC | Read the Annual Notice of Change your plan sends in September. | Premiums, deductibles, copays, out-of-pocket limits, provider networks, drug coverage, and benefits |
| 2. Assess your needs | Consider how your overall health and prescriptions have chnaged over the past year. | Whether your preferred providers/facilities, regular medications, and necessary services are covered, and total estimated costs |
| 3. Compare your options | Talk to a SHIP counselor (1-877-839-2675) to see if another plan may better meet your needs. | Compare plans iwth Medicare Plan Finder |
Note: The annual Open Enrollment period does not apply to Medigap.
Steps to get ready for Medicare Open Enrollment
Step 1: Review your Annual Notice of Change
Medicare plans change every year, so it’s important to reevaluate how well your plan fits your needs. You should have recently received your plan’s Annual Notice of Change (ANOC) in the mail prior to the start of Open Enrollment—usually in September. It summarizes the changes in your plan’s cost and coverage in the coming year.
When reviewing your ANOC, there are some key components to consider:
- Premium: Are you going to pay more, less, or the same amount each month for your current plan?
- Deductible: Is the amount you have to pay out of pocket before your coverage kicks in going to increase, decrease, or stay the same?
- Maximum out-of-pocket cost: Will there be a change to the maximum amount you will have to pay for the year before your plan starts to cover all costs?
- Copayment/coinsurance: Will the amount you have to pay out of pocket for each service—or, in some cases, drugs—change?
- Network: Are there any changes to the providers, facilities, and pharmacies in your network?
- Drug coverage: If you have Medicare Part D, have any drugs you might need been added or removed from your plan's drug list (formulary)? Have any been moved to a different tier, changing the price you can expect to pay?
- Other changes: Will there be new services covered, previous services ending, or other changes to services under your plan?
As you can see, the ANOC is an important document that makes it easier to determine if your current Medicare plan still works for your needs, lifestyle, and budget. If you don’t receive your ANOC by September 30, you should contact your plan to request it.
Step 2: Assess your coverage needs
Once you’ve reviewed the ANOC and your needs over the past year, you can assess your coverage options for Medicare Advantage and/or Medicare Part D. Here are a few things you should consider in order to answer the question “Should I switch Medicare plans during Open Enrollment?”:
- Think about your health care needs over the past year. Has your health status changed, requiring you to see a new specialist or receive a new set of services? Is your plan continuing to meet your needs?
- Are Medicare Advantage plans worth it? Are the providers and services you need covered by the plan? This includes preferred doctors/specialists, treatments, and supplemental benefits. When comparing plans, be sure you understand the limitation on each benefit.
- Does Medicare pay for prescriptions that matter to your health? Does the plan you’re considering cover all the drugs you think you will need in 2027? Be sure to ask about any restrictions, such as quantity limits, or whether your drugs require prior approval from the plan.
- What out-of-pocket costs will you incur when you see a doctor, require a hospital stay, or pick up prescriptions at the pharmacy? Most plans have an annual out-of-pocket-maximum, but prescription drug costs are not included in that amount.
Step 3: Get trusted Medicare advice
What is the average cost of supplemental insurance for Medicare (Medigap)? Which type of care is not covered by Medicare? There are many considerations when choosing a Medicare plan, and it is normal to feel overwhelmed by the information and decision making. Here are a couple of resources where you can talk to trained, trusted Medicare counselors free of charge:
- For help understanding your Medicare options and how to save money on your out-of-pocket health care costs, contact your local State Health Insurance Assistance Program (SHIP) by calling 1-877-839-2675 or visiting their website. SHIPs use trained volunteers to offer trusted, unbiased Medicare counseling.
- Compare coverage options and shop for plans using the Medicare Plan Finder or call 1-800-MEDICARE to talk with a customer support representative. TTY users should call 1-877-486-2048. The Medicare Support Hotline is available 24/7, except for some federal holidays.
We encourage you to start browsing plans early for the upcoming Open Enrollment Period. If you use the trusted resources above, you won't have to navigate the decision-making process alone.
Need Help Understanding Medicare Enrollment?
Timing is critically important when it comes to enrolling in Medicare. If you think you will want Medicare at any point in your life—and you most likely will—you need to understand when you can and should enroll.
