Medicare Open Enrollment runs from October 15 through December 7, 2026. Eligible people can review coverage for 2027 and make certain changes. Changes made during this period generally take effect January 1, 2027. Your plan must receive your enrollment request by December 7.
You do not have to switch just because the window opens. But it is a good time to check whether your current plan will still fit your health needs, prescriptions, providers, budget, and travel routine next year.
We’ve covered what to do when coverage is denied and how to raise a grievance; now let’s look at the coverage choices you can review this fall.
First, know what you can change
During Medicare’s Annual Open Enrollment Period, you may be able to:
- Switch between Original Medicare and Medicare Advantage.
- Change from one Medicare Advantage plan to another.
- Join, change, or drop a Medicare Part D prescription drug plan, subject to applicable rules and your current coverage.
Your options depend on the coverage you have now. If you are considering a move from Medicare Advantage to Original Medicare, check whether you need a separate Part D plan and whether you can obtain Medigap coverage under the rules that apply to you. Do not assume you can add Medigap at any time or on the terms you expect. Medicare explains some of these considerations on its Open Enrollment page.
The 10-minute plan comparison checklist
Think of this as a quick first pass, not a promise that every detail can be checked in ten minutes. Gather your plan’s Annual Notice of Change, a current medication list, and the names of the doctors and facilities you rely on. Then compare the details that matter to you.
Look beyond the monthly premium
Compare the plan’s:
- Monthly premium
- Deductible
- Copays and coinsurance
- Maximum out-of-pocket, if the plan has one
A lower premium does not necessarily mean lower total costs. Consider how often you use care and what you may pay when you do. Original Medicare and Medicare Advantage also have different cost structures, so compare the coverage type as well as the price.
Check your actual medications and pharmacy
Enter each medication into Medicare Plan Finder, including the dose and how often you take it. Check:
- Whether each medication is on the plan’s formulary, or covered-drug list.
- Its tier, which can affect your share of the cost.
- Whether the plan requires prior authorization or has other coverage limits.
- Whether your pharmacy is preferred or in the plan’s network.
A drug’s coverage or cost can change from one plan year to the next. Confirm the details for the plan year you are considering.
Confirm your doctors, hospitals, and specialists
Check the network for the providers and facilities you actually use, including primary care doctors, specialists, hospitals, and other regular providers. If keeping a particular provider matters, confirm the provider’s participation directly with the plan. Provider directories and networks can change.
Also check the plan’s service area. Medicare Advantage plan availability and terms can depend on your county and address.
Review the plan’s quality rating
CMS star ratings can provide one comparison point for Medicare Advantage and Part D plans. They do not tell you whether a plan’s network, costs, or drug coverage fit your needs. Review ratings alongside the other details, using Medicare’s plan comparison tool.
Pause before you submit
Before enrolling, check that you are comparing the correct plan and coverage year. Ask the plan to confirm details you cannot verify, and save your notes and enrollment confirmation. If you are unsure what a change could mean for your current coverage, ask Medicare or a SHIP counselor before submitting an application.
Hypothetical example: A person sees a plan with a lower monthly premium and considers switching. Before enrolling, they check their specialist’s network status, a medication’s tier, and the cost-sharing for care they use regularly. Those details may change how useful the plan is to them.
Snowbird check: coverage in both states
If you divide your year between Western New York and Florida’s Gulf Coast, check access to routine care in both places. A plan that fits your needs near Buffalo may not offer the same provider access when you are in Clearwater, St. Petersburg, Dunedin, Largo, Safety Harbor, or Bradenton.
Before choosing or keeping a plan, ask:
- Are the doctors, specialists, hospitals, and pharmacies you expect to use in each location in network?
- What coverage applies to urgent and emergency care away from your home area?
- Does the plan type affect your access to routine or out-of-network care?
- Does the plan have travel, visitor, or extended-absence rules?
- Is the plan available in your county of residence?
Do not assume that every Medicare Advantage plan covers routine care in both states, or that every plan is available where you spend the winter. Original Medicare, Medicare Advantage, and Part D have different rules. Confirm the specific details with the plan and consider both addresses and care routines when comparing options.
This is different from the January–March period
The Medicare Advantage Open Enrollment Period runs from January 1 through March 31. It is for people who are already enrolled in Medicare Advantage at the start of that period. Generally, they can make one change: switch to another Medicare Advantage plan or leave Medicare Advantage and return to Original Medicare. A person returning to Original Medicare may also join a stand-alone Part D plan.
This is not a second general Open Enrollment Period. If you have Original Medicare, you generally cannot use the January–March period to join Medicare Advantage. For details, check the official Medicare enrollment information.
Where to get help
You can compare options and get neutral guidance from:
- Medicare Plan Finder: medicare.gov/plan-compare
- SHIP: State Health Insurance Assistance Programs offer unbiased Medicare counseling. Find your local program at shiphelp.org.
- Medicare: Call 1-800-MEDICARE (1-800-633-4227) or visit Medicare’s contact page.
Medicare plan questions belong with Medicare, the plan, or a SHIP counselor. A CPA or financial advisor can help with tax questions.
How Medicare fits into broader planning
Choosing a Medicare plan is an insurance decision, not legal advice. But your coverage choices can be one part of a broader conversation about care, finances, and support as you age.
At Santopolo Law, we help families with Medicaid and estate planning, not with choosing Medicare insurance plans. If you are thinking about long-term care and how it may affect your family or assets, learn more about our Elder Law & Medicaid Planning. If you own property in New York and Florida, our snowbird estate planning information may also be helpful.
You do not need to make a rushed change tomorrow. Take time to confirm the details that matter to you, and submit any enrollment request by December 7, 2026 if you decide to change plans.
If you have questions about planning for your family’s future, contact Santopolo Law, PLLC. We are here to help you understand your estate and Medicaid planning options.
General Information Disclaimer: This article provides general information, not legal advice, Medicare advice, or insurance advice. Laws, plan terms, and policies vary and may change. Reading this article does not create an attorney-client relationship.
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