What to Review Before Medicare Open Enrollment Ends
Medicare Open Enrollment runs from October 15 to December 7, and it's the one time each year when anyone with Medicare can switch Medicare Advantage or Part D plans, with changes starting January 1. Plans change their costs, networks, and benefits every year, so even if you're happy with your coverage, a quick review can save money and prevent surprises. Here are 10 things to review before Medicare Open Enrollment ends.
1. Your Annual Notice of Change
Your plan mailed this letter by September 30. It lists exactly what's changing next year: premiums, deductibles, copays, covered drugs, and network changes. It's the fastest way to spot anything that affects you, and many people never open it.
2. Your Doctors and Hospitals
If you have a Medicare Advantage plan, confirm that your primary care doctor, specialists, and preferred hospitals will still be in network next year. Networks change, and a doctor leaving your plan can mean higher costs or finding a new provider. If you need a new doctor, see our guide to Medicare after 70 for questions to ask.
3. Your Prescriptions
Check that each of your medications is still on your plan's drug list, called the formulary, and on the same cost tier. Also check whether your pharmacy is still preferred and whether any drugs will need prior authorization. In 2026, Part D caps your yearly out-of-pocket drug costs at $2,100, and the cap adjusts each year. For more, see our Medicare prescription coverage guide.
4. Your Total Yearly Costs
Don't stop at the monthly premium. Add up what you'd likely pay in a year: premiums, deductibles, copays for the care you use most, and drug costs. For Medicare Advantage, also check the plan's yearly out-of-pocket maximum, which limits what you pay for covered care in a bad health year.
5. Your Extra Benefits and Allowances
Many Medicare Advantage plans include dental, vision, hearing, fitness, or over-the-counter allowances. Check what's changing next year, and use any remaining benefits this year, since many allowances reset on January 1 and don't roll over.
6. Prior Authorization and Referral Rules
If you had trouble getting approvals this year for tests, procedures, rehab, or equipment, check whether next year's plan has the same rules. A plan with fewer hurdles for the care you need can be worth a slightly higher premium.
7. Your Plan's Star Rating
Medicare rates Medicare Advantage and Part D plans from 1 to 5 stars based on quality and member experience. Compare your plan's rating with other plans in your area. If a 5-star plan is available where you live, you may be able to switch to it once outside of Open Enrollment, too.
8. Help Paying Your Costs
If your income and savings are limited, check whether you qualify for programs that many eligible people never apply for. Extra Help lowers Part D drug costs, and Medicare Savings Programs can help pay Part B premiums and other costs. Your State Health Insurance Assistance Program (SHIP) can help you apply.
9. Whether Your Coverage Path Still Fits
Consider whether Original Medicare with a Medigap plan and Part D, or a Medicare Advantage plan, better fits how you use care now. Keep in mind that if you leave Medicare Advantage for Original Medicare, buying a Medigap plan later may require answering health questions in most states. For more on choosing, see what Medicare covers and what else seniors need.
10. Life Changes and Travel Plans
Moving, spending winters in another state, a new diagnosis, or plans to travel more can all change which plan works best. Medicare Advantage networks are usually local, so frequent travelers should check out-of-area coverage carefully.
Key Medicare Dates to Know
| Date | What happens |
|---|---|
| By September 30 | Plans send the Annual Notice of Change |
| October 15 to December 7 | Medicare Open Enrollment: join, switch, or drop a Medicare Advantage or Part D plan |
| January 1 | New coverage and costs take effect |
| January 1 to March 31 | Medicare Advantage members can switch plans once or return to Original Medicare |
How to Compare Plans and Make a Change
- Medicare's Plan Finder on Medicare.gov lets you enter your ZIP code and prescriptions to compare plans side by side.
- 1-800-MEDICARE (1-800-633-4227) is available 24 hours a day.
- Your State Health Insurance Assistance Program (SHIP) offers free, unbiased one-on-one counseling.
- Licensed agents can help you enroll, but they're paid by insurers and may not offer every plan.
If you're happy with your plan and nothing important changed, you don't need to do anything; your coverage usually continues automatically.
The Bottom Line
A short review before December 7 can protect your budget and your access to the doctors and drugs you rely on. Read your Annual Notice of Change, check your doctors, prescriptions, total costs, and extra benefits, and compare at least a few plans. If your current plan still fits, you're all set; if not, Open Enrollment is your chance to switch.
This article is general information and isn't affiliated with Medicare or any insurance company. Confirm details with Medicare.gov, 1-800-MEDICARE, or your State Health Insurance Assistance Program.