Key Takeaway: Medicare’s annual Open Enrollment period runs from October 15 through December 7. During this window, you can switch from Original Medicare to a Medicare Advantage plan (or vice versa), change Medicare Advantage plans, add or drop Part D prescription drug coverage, and adjust your current plan. Any changes you make take effect January 1 of the following year.

Medicare Open Enrollment arrives every fall, giving beneficiaries a limited window to review their health coverage and make changes for the upcoming year. Whether you are enrolled in Original Medicare, a Medicare Advantage plan, or a standalone Part D prescription drug plan, this period is the one opportunity each year to adjust your coverage without a qualifying life event.

Many beneficiaries stay in the same plan year after year without reviewing whether it still meets their needs. Health conditions change, prescription drug lists (formularies) are updated, provider networks shift, and premiums can increase. Taking time during Open Enrollment to compare your options ensures you have the coverage that fits your current medical and financial situation.

What You Will Learn

This guide walks you through the steps to review your Medicare coverage during Open Enrollment. You will learn how to assess your current plan, identify changes in coverage or costs, compare alternative options, and make informed decisions before the December 7 deadline.

Step 1: Review Your Current Coverage and Costs

Start by gathering your current plan documents, including your Annual Notice of Change (ANOC) and Evidence of Coverage (EOC). The ANOC, mailed in late September, details any changes to your plan for the upcoming year, including premium adjustments, formulary updates, and network changes.

Review these specific items:

  • Monthly premium (Part B, Part D, or Medicare Advantage plan premium)
  • Deductibles and out-of-pocket maximums
  • Copays for doctor visits, specialist care, and hospital stays
  • Prescription drug formulary (the list of covered medications and their tier placement)
  • Provider network (confirm your doctors and hospitals are still in-network)

According to the Centers for Medicare & Medicaid Services, plan costs and coverage can change significantly from year to year (CMS, 2026). A plan that worked well last year may no longer be the best fit.

Step 2: Assess Your Health Care Needs for the Coming Year

Evaluate your expected medical needs for the next 12 months. Consider:

  • Prescription medications you take regularly (check if they remain on your plan’s formulary and at what tier)
  • Planned procedures or surgeries
  • Specialists you see regularly (verify they are in-network)
  • Frequency of doctor visits and anticipated costs
  • Need for additional benefits (dental, vision, hearing aids, gym memberships)

If your health status has changed since you enrolled in your current plan, your coverage needs may have shifted. A plan with higher premiums but lower copays might save money if you anticipate frequent medical visits, while a lower-premium plan could work better if you are generally healthy.

Step 3: Compare Plans Using Medicare’s Plan Finder

The official Medicare Plan Finder tool at Medicare.gov allows you to compare all available plans in your area. Enter your zip code, current medications, and preferred pharmacies to see personalized cost estimates.

The tool shows:

  • Total estimated annual costs (premiums plus out-of-pocket expenses)
  • Star ratings (Medicare rates plans on a 5-star scale for quality and performance)
  • Coverage details for your specific prescriptions
  • In-network providers and pharmacies

Compare at least three plans, including your current one. According to Medicare.gov, the Plan Compare tool updates daily with the most current plan information (Medicare Plan Compare, 2026).

Read also: Medicare Open Enrollment 2026: Key Decisions Before December 7 in the US

Step 4: Understand Your Coverage Options

You have several options during Open Enrollment:

  • Switch from Original Medicare (Parts A and B) to a Medicare Advantage plan
  • Switch from a Medicare Advantage plan back to Original Medicare
  • Change from one Medicare Advantage plan to another
  • Add, drop, or switch Part D prescription drug plans
  • Keep your current coverage without changes

Medicare Advantage plans bundle hospital, medical, and often prescription drug coverage into one plan, frequently with additional benefits like dental and vision. Original Medicare offers more provider flexibility but typically requires a separate Part D plan and possibly a Medigap supplement.

Step 5: Enroll in Your New Plan

Once you have selected a plan, you can enroll online through Medicare.gov, by phone at 1-800-MEDICARE (1-800-633-4227), or by contacting the plan directly. Keep a record of your enrollment confirmation.

If you are switching plans, you do not need to disenroll from your old plan first. Your new plan enrollment automatically cancels your previous coverage effective January 1.

Practical Tips for a Smooth Review

  • Start early in the Open Enrollment period to avoid last-minute decisions
  • Contact your State Health Insurance Assistance Program (SHIP) for free, unbiased counseling
  • Check if your prescriptions moved to a different tier or require prior authorization
  • Verify that mail-order pharmacy options are available if you use them
  • Review the plan’s Summary of Benefits document for the full picture of what is covered

Common Mistakes to Avoid

Many beneficiaries make avoidable errors during Open Enrollment:

  • Ignoring the Annual Notice of Change and assuming nothing has changed
  • Focusing only on premium costs without considering total annual out-of-pocket expenses
  • Failing to verify that prescriptions remain covered at the same cost
  • Missing the December 7 deadline (late enrollment may result in coverage gaps or penalties)
  • Choosing a plan based on last year’s needs rather than anticipated future needs

Frequently Asked Questions

When exactly is Medicare Open Enrollment?
Open Enrollment runs from October 15 through December 7 every year. Changes take effect January 1.

Can I change my Medigap policy during Open Enrollment?
Medicare Open Enrollment does not apply to Medigap (Medicare Supplement Insurance) policies. You can apply for Medigap anytime, but outside your Medigap Open Enrollment Period (the six months after you turn 65 and enroll in Part B), insurers can deny coverage or charge higher premiums based on health conditions.

What if I miss the deadline?
If you miss the December 7 deadline, you generally must wait until the next Open Enrollment period unless you qualify for a Special Enrollment Period due to a life event like moving or losing other coverage.

How do I know if my plan is good?
Check your plan’s Star Rating on Medicare.gov. Plans are rated 1 to 5 stars based on quality measures. Also compare your total estimated annual costs using the Plan Finder tool.

Take Action Before the Deadline

Medicare Open Enrollment is your annual opportunity to ensure your health coverage aligns with your current needs and budget. Review your plan documents, compare your options using Medicare’s tools, and make changes before December 7. If you need assistance, contact your local SHIP or call 1-800-MEDICARE for guidance.

Important: This information is educational and general in nature. Medicare coverage rules, plan availability, and costs vary by location and individual circumstances. Verify current plan details and enrollment requirements with Medicare.gov or a licensed insurance agent before making coverage decisions. Medicare Open Enrollment dates and plan terms are subject to change by federal regulation.