Medicare Open Enrollment: How to Choose the Right Coverage
Medicare’s Fall Open Enrollment Period is an important opportunity to review your health coverage and make changes for the coming year. With so many plan options—and so much mail—it can be hard to know where to begin.
In this guide, we will help you understand what you can do during Open Enrollment, how to protect yourself along the way, and help ensure your coverage meets your needs.
1. When Is Medicare Open Enrollment?
Medicare’s Open Enrollment Period runs October 15 through December 7 each year. Any changes you make during this time take effect on January 1 of the following year.
This is the only annual window when most people can make changes to their Medicare Advantage or Part D (prescription drug) coverage without a special enrollment reason.
2. What Changes Can You Make During Open Enrollment?
During Open Enrollment, Medicare allows you to:
Add, drop, or change a Medicare Advantage plan
Switch from Medicare Advantage back to Original Medicare
Enroll in, drop, or change a stand‑alone Part D prescription drug plan
You are allowed to make multiple changes during the Open Enrollment period. However, only your final selection will take effect on January 1.
If you return to Original Medicare, be aware that your ability to purchase a Medigap (Medicare Supplement) policy may be limited. Medigap rules vary by state, and coverage may not be guaranteed outside of certain enrollment windows.
3. Why It’s Important to Review Your Coverage Each Year
Even if you are satisfied with your current plan, it is still wise to review your options annually. Plans often change their:
Premiums and deductibles
Copayments and coinsurance
Provider and pharmacy networks
Prescription drug formularies
In some cases, you may find the same or better coverage at a lower cost, simply by switching plans.
4. What to Review Before Choosing Your 2026 Coverage
Before making any changes, take time to evaluate your current coverage. Consider:
Whether your doctors and specialists are still in‑network
Whether your preferred pharmacies are included
Whether your prescriptions are still covered
Your total annual costs, including premiums and out‑of‑pocket expenses
If you have Original Medicare, review the 2026 Medicare & You handbook or visit Medicare.gov to understand available benefits.
If you have a Medicare Advantage or Part D plan, carefully review your plan’s:
Annual Notice of Change (ANOC)
Evidence of Coverage (EOC)
These documents explain what is changing in 2026. If any changes affect your providers, medications, or costs, you can choose a different plan during Open Enrollment.
5. Get Free, Unbiased Help from SHIP
You do not have to navigate Medicare alone. Your State Health Insurance Assistance Program (SHIP) offers free, unbiased counseling to help you compare plans and understand your options.
SHIP counselors are government‑funded and do not sell insurance. To find your local SHIP, you can use the SHIP Locator or call 877‑839‑2675 and say “Medicare” when prompted.
6. How to Make Changes to Your Medicare Coverage
Once you decide on a plan, you can enroll by:
Calling 1‑800‑MEDICARE
Visiting Medicare.gov to compare plans and enroll online
Contacting the plan directly to enroll
Before enrolling, confirm that:
Your doctors participate in the plan’s network
Your medications are covered
All plan details are in writing
Never rely solely on verbal representations when making a final decision.
7. Protect Yourself from Medicare Marketing Violations
Medicare has specific rules about how plans and agents can market their services. Knowing these rules can help protect you from aggressive or misleading tactics.
Important protections include:
Plans may send mail, but cannot call, email, visit your home, or approach you in public unless you give permission
Plans and agents cannot claim to be endorsed by Medicare or use the Medicare name or logo
Agents must provide a Scope of Appointment (SOA) form that limits what can be discussed
The enrollment meeting must occur at least 48 hours after agreeing to the SOA
Agents must review a plan’s impact on your current coverage, including providers, prescriptions, and costs
If you suspect improper behavior, contact your Senior Medicare Patrol (SMP) or SHIP to report potential violations.
Final Thoughts
Medicare Open Enrollment is an important annual opportunity to ensure your health coverage remains affordable, accessible, and aligned with your needs. Taking time to review your options—and seeking trusted assistance when needed—can help you make confident decisions for the year ahead.
If you have questions about how Medicare choices may fit into your broader retirement or financial planning, consider speaking with your attorney or a knowledgeable professional who can help you evaluate the full picture.