Medicare Open Enrollment: The 5 Things Worth Checking

Every fall, people with Medicare get a window to review their health and drug coverage and decide whether to change it. Medicare’s own guidance says costs, benefits, and providers can change each year. Staying with the same plan without a review can therefore mean different coverage than you had the year before.

Open enrollment runs from October 15 to December 7. This article covers five areas the official guidance points to: the dates and rules, plan changes, prescription drugs, doctors and pharmacies, and overall costs.

1. The Dates and What You Can Change

According to Medicare.gov, during the October 15 – December 7 Open Enrollment Period you can:

• Join, drop, or switch to another Medicare Advantage Plan, with or without drug coverage.
• Switch from Original Medicare to a Medicare Advantage Plan, or from a Medicare Advantage Plan back to Original Medicare.
• Join, drop, or switch to another Medicare drug plan if you have Original Medicare.

Coverage starts January 1 of the next year. The plan must receive your request to join by December 7. Medicare’s yearly review guide adds that you can also ask for a paper enrollment form and mail it back, and the plan must get it by that same date.

A second window for Medicare Advantage members

People already in Medicare Advantage have another opportunity after the new year. The Medicare Rights Center explains that the Medicare Advantage Open Enrollment Period runs January 1 through March 31. It is limited to people currently enrolled in Medicare Advantage, with certain exceptions such as Medical Savings Accounts, cost plans, and PACE. Enrollees can make one change only. They can switch to a different Medicare Advantage plan or move to Original Medicare, with or without Part D coverage.

2. What Is Changing in Your Current Plan

Medicare’s guidance says that comparing your options could help you find better coverage or save money. Because plan costs, benefits, and provider networks can shift from year to year, the first step is to look at what your current plan will look like next year, not only what it looked like this year.

Kiplinger’s open enrollment guide lays out a typical timeline. The Part B premium and the Part A and Part B deductibles for the coming year are released in late October or early November. Notices about income-related surcharges (IRMAA) and Social Security cost-of-living adjustments arrive in November or December.

3. Prescription Drug Coverage

Drug coverage is one of the areas where the rules have changed recently. Several consumer and policy sources report these 2026 figures:

• Part D enrollees face a $2,100 cap on annual out-of-pocket prescription drug costs in 2026. That is up from $2,000 in 2025, the first year the cap applied.
• The same AARP report says the maximum Part D deductible rises to $615 in 2026, from $590 in 2025. Some plans have lower deductibles or none at all.
• U.S. News reports that negotiated prices for the first 10 drugs selected under the Inflation Reduction Act took effect in 2026. Eliquis and Jardiance are among them.

Because individual plans differ, Medicare says Medicare.gov/plan-compare can give you customized coverage and cost information for your preferred pharmacies and any prescription drugs you take. Checking each medication and pharmacy against a plan’s details is the most direct way to see how a plan treats your own prescriptions.

4. Your Doctors, Providers, and Pharmacies

Plan networks can change. The Medicare plan finder lets you search for your doctors and other providers to find out whether they’re in the network of the plans you are considering. The same tool shows quality and customer service ratings from current plan members.

Medicare describes two main ways to get coverage. Original Medicare is Part A (hospital insurance) and Part B (medical insurance), with an option to add a separate Part D drug plan. Medicare Advantage (Part C) consists of Medicare-approved plans from private companies that bundle Part A, Part B, and usually Part D. Knowing which of these you have tells you which provider and pharmacy questions apply to you.