Medicare Open Enrollment Is Here

What to Review Before December 7

Each year, Medicare beneficiaries have an opportunity to review their coverage and make changes during Medicare Open Enrollment.  During this period, beneficiaries can make changes to Medicare Advantage and prescription drug coverage or move between Medicare Advantage and Original Medicare.

Even if you are generally satisfied with your current coverage, it is important to take time to review your options.  Plans can change from year to year, and the coverage that worked well for you in the past may not be the best fit for your needs going forward. 

Medicare Open Enrollment runs October 15 through December 7, 2026, with coverage changes taking effect January 1, 2027.  Here are some key steps to help you make an informed decision for the coming year.

1. Start With Your Annual Notice of Change

If you are enrolled in a Medicare plan, you should have received an Annual Notice of Change (ANOC) in September.  This document outlines any changes to your plan’s costs and coverage that will take effect in January.  Reviewing these changes carefully can help you determine whether your current plan will continue to meet your needs.  If you have not received your notice, contact your plan to request a copy.   

As you review your coverage, consider the following:

• Are premiums, deductibles or other out-of-pocket costs changing?
• Are your doctors and preferred hospitals still in-network?
• Are your prescriptions still covered, and have their costs or formulary tiers changed?
• Have copays or coinsurance changed?
• Are benefits you use being added, reduced, or eliminated?

While your plan’s premium is an important consideration, it is equally important to evaluate how your coverage aligns with your doctors, prescriptions, and anticipated health care needs.

2. Compare – Even If You Like Your Current Plan

If you are happy with your current coverage, you may be tempted to skip the comparison process altogether.  However, reviewing other available plans can help you determine whether your existing coverage remains the best choice.

Medicare offers an online tool, the Medicare Plan Finder, that allows you to compare Medicare Advantage and prescription drug plans available in your area.  By personalizing your search, you can better understand how different plans may meet your specific needs.

Before beginning your comparison, gather a list of your:

• Doctors and specialists
• Preferred hospitals
• Prescription drugs and dosages
• Preferred pharmacies

Entering your prescription information can help generate more accurate estimates of your anticipated drug costs.  You can also review provider networks, plan benefits, and other out-of-pocket expenses to get a clearer picture of how each option compares.

Taking these factors into account provides a more meaningful comparison than simply choosing the plan with the lowest premium or the longest list of additional benefits.

3. Be Careful About Where You Get Medicare Advice

Medicare choices can be complicated, and professional guidance can be valuable.  However, not every agent or broker represents every plan available in your area.  Understanding which plans are being presented, and which may be excluded, is an important part of making an informed decision.

Changes to Medicare marketing rules for the 2027 enrollment season make this especially relevant. 

Under previous rules, agents and brokers subject to Medicare’s third-party marketing disclosure requirements had to explain within the first minute of a sales call that they did not necessarily represent every plan available in a particular area. 

Under the new rules, this disclosure is still required, but it can be provided later in the conversation, as long as it occurs before plan benefits are discussed.  Additionally, agents and brokers are no longer required to include information about State Health Insurance Assistance Programs (SHIPs) in that disclosure. 

These changes make it particularly important for beneficiaries to ask questions and understand the scope of the information they are receiving. 

Another consideration is whether you are working with an independent or captive insurance agent.  Independent agents generally work with multiple insurance companies and can present plans from the companies they represent.  Captive agents typically represent one insurance company and offer its products. 

However, even independent agents may not have access to every plan available in your area.  Before relying on a recommendation, ask which insurance companies and plans the agent represents.

For additional guidance, consider reviewing the information available at Medicare.gov or contacting your local State Health Insurance Assistance Program (SHIP). SHIP counselors provide free, unbiased Medicare counseling and can help you better understand your coverage options. 

4. Medicare Open Enrollment Is Also Prime Time for Scams

Unfortunately, Medicare Open Enrollment also creates opportunities for scammers looking to take advantage of beneficiaries who may be confused about their coverage options.

Medicare reminds beneficiaries to protect their Medicare number and other personal information.  Medicare will never call to sell you something or visit your home uninvited to sell Medicare products.    

Be alert for the following warning signs:

• Unsolicited callers requesting your Medicare number or Social Security number
• Someone claiming your benefits will be canceled unless you act immediately
• Requests for banking or credit card information
• High-pressure pitches urging you to change plans immediately
• Someone appearing at your home uninvited, claiming to represent Medicare
• Offers of cash or valuable gifts in exchange for enrolling in a plan

Medicare also has specific marketing rules for health plans. For example, plan representatives generally cannot contact you by phone unless you are already a member or have given permission to be contacted.  They also cannot visit your home uninvited to sell a plan or ask for payment over the phone or online. 

If you are unsure who you are communicating with, do not provide personal information.  End the conversation and contact Medicare directly at 1-800-MEDICARE (1-800-633-4227) or visit Medicare.gov to verify the information you have received.   

Make an Informed Decision for the Year Ahead

Health coverage is an important part of your broader financial picture.  Medicare Open Enrollment isn’t necessarily about changing plans every year.  Rather, it provides an opportunity to make sure your existing coverage continues to align with your health needs, prescriptions, preferred providers, and budget. 

Taking time to review your options can help you avoid unwelcome surprises when new coverage and costs take effect in January.  If you would like to learn more, please contact us.

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