Medicare Open Enrollment 2026: What You Need to Know

Fall brings more than football and cooler temperatures. It also signals the approach of Medicare Open Enrollment, an important opportunity to review your healthcare coverage for the coming year.

Each year, from October 15 through December 7, Medicare beneficiaries have the opportunity to review and make changes to their coverage for the upcoming year. Any changes made during this period take effect on January 1, 2027.

Even if you’re satisfied with your current coverage, this is the perfect time to review your plan. Changes to premiums, prescription drug coverage, provider networks, and benefits happen every year, which means the plan that worked well this year may not be the best fit for next year. A few minutes spent reviewing your Medicare Plan options could potentially save money, improve coverage, and help you avoid unexpected healthcare costs in 2027.

Why Should I Review My Medicare Coverage Each Year?

Even if your health has not changed, your plan might have.

Insurance companies can adjust:

• Monthly premiums
• Deductibles and copays
• Prescription drug formularies
• Provider and hospital networks
• Additional benefits, such as dental, vision, or hearing coverage

These changes are outlined in the Annual Notice of Change (ANOC) that plan members typically receive in late September. Reviewing this document can help you avoid surprises in the coming year.

What Changes Can I Make During Medicare Open Enrollment?

During the Medicare Open Enrollment period, you can:

• Switch from Original Medicare to a Medicare Advantage plan
• Switch from Medicare Advantage back to Original Medicare
• Change from one Medicare Advantage plan to another
• Enroll in a Part D prescription drug plan
• Change Part D prescription drug plans

Any enrollment changes completed by December 7 become effective January 1.

What Should I Review Before Choosing a Medicare Plan for Next Year?

Before making any decisions, take a few minutes to evaluate:

• Your Medications: Prescription drug costs can vary significantly from one plan to another. Verify that your medications are still covered and determine whether their tier placement has changed.
• Your Doctors: If you have a Medicare Advantage plan, make sure your preferred physicians, specialists, and hospitals remain in the network.
• Your Healthcare Needs: Have you experienced any changes in your health this year? A plan that worked well in the past may not be the best fit for the future.
• Total Costs: Don’t focus solely on the monthly premium. Consider deductibles, copays, out-of-pocket maximums, and prescription costs to understand the full financial impact of a plan.

What Are Common Medicare Open Enrollment Mistakes to Avoid?

• Automatically renewing your current plan without reviewing it. Even if your coverage worked well this year, plan costs, benefits, provider networks, and prescription drug coverage can change from year to year.
• Looking only at the monthly premium. A lower premium doesn’t always mean lower overall costs. Consider deductibles, copays, prescription expenses, and out-of-pocket maximums when comparing plans.
• Overlooking your prescription drug coverage. Check that your medications are still covered and review any changes to pricing or coverage tiers that could affect your costs.
• Not confirming your doctors and hospitals are still in-network. Provider networks can change annually, especially with Medicare Advantage plans.
• Waiting until the last minute. Giving yourself plenty of time to compare options can help you avoid rushed decisions and ensure you choose coverage that best fits your needs.
• Missing the December 7 deadline. Once Open Enrollment ends, your ability to make changes may be limited until the next enrollment period, so it’s important to review your options and act on time.

Where Can I Get Guidance on Medicare Decisions?

Medicare can be complicated, and the number of available plan choices can feel overwhelming. The good news is that you don’t have to make these decisions by yourself.

As part of our commitment to helping clients navigate retirement with confidence, we’re happy to discuss Medicare-related concerns and help point you toward resources that can assist you in evaluating your options. The goal isn’t necessarily to change your coverage every year. It’s to make sure the coverage you have continues to meet your needs and budget.

TFG is proud to have Amy Pucci, Certified Senior Advisor (CSA)® as our in-house Medicare specialist. Amy has over 15 years of experience working with retirees and is deeply knowledgeable about Medicare, Social Security, and aging transitions. She regularly consults with clients to help them navigate the complexities of Medicare and make confident, informed decisions.

Amy is available to assist you with:

• Reviewing your current Medicare coverage
• Comparing Medicare Supplemental, Advantage and Part D plans
• Understanding how changes in your health or medications may affect your coverage
• Avoiding common enrollment mistakes and scams

Her guidance can help you avoid costly errors and ensure your healthcare coverage supports your retirement goals. A little time spent reviewing your options today can potentially save money, improve coverage, and provide greater peace of mind in the year ahead.

If you have any questions about Medicare and how it fits into your overall retirement plan, we’re here to help. Contact us to schedule a Medicare review with Amy today.