Original article written by:
Elaine Floyd, CFP®
Director, Retirement and Life Planning
Horsesmouth, LLC
If you are eligible for Medicare, you likely received an Open Enrollment packet in the mail where you can see how your plan might change next year. You can check premiums, copayments, covered drugs, provider networks, and so on. If you are in Part D drug plans, you can see how your drug plan might change next year.
What the respective packets don’t show is the insurers’ competition—what other Medicare Advantage plans and drug plans will be like for next year. And this is why you should devote some time to not only evaluating your existing plan and how it will be changing for next year, but also what other plans are out there, including new entrants to the market. The Medicare market is very profitable—and highly competitive—for insurers, and this can work in your favor. It pays for everyone to shop around every year at this time. Here are some things to know about Fall Open Enrollment:
1. Fall Open Enrollment starts October 15 and ends December 7.
During this time, you can:
- Switch from one drug plan to another
- Switch from Medicare Advantage to Original Medicare
- Switch from one Medicare Advantage plan to another
You should take time to review not only how your current plan will change for next year, but also what other plans are available—including new options. The Medicare market is highly competitive, and shopping around each year can help you find the best fit.
2. The total number of drug plans is decreasing in 2026, but you’ll still have a choice of 8–12 plans.
Surprisingly, drug plan premiums are decreasing for many plans in 2026. Premiums will range from $0 to $100. If you take expensive drugs, you may need to pay higher premiums, but if you don’t take any drugs, you can choose a lower-premium plan. If your needs change, you can change plans in the future.
Medicare Advantage plans are required to cover the same services as Original Medicare, but deductibles, premiums, and cost-sharing vary by plan. Evaluate Medicare Advantage plans based on your expected health care usage.
If you switch from Medicare Advantage to Original Medicare, you’ll need to get a Part D drug plan and should also consider a Medigap (Medicare supplement) policy. Unless you’re in your Medigap open enrollment period (the six months after enrolling in Part B), you may have to go through medical underwriting, depending on your state.
3. Help is available—use Medicare’s Plan Finder Tool.
The Plan Finder Tool helps you compare Part D and Medicare Advantage plans based on your medications, pharmacy, and costs. If you research a plan online, also call the plan directly to confirm what you’ve learned. Make sure your doctors and hospitals are in the plan’s network, and that your drugs and pharmacies are covered. Write down the date, the representative’s name, and any outcomes or next steps from your conversation—this can help protect you if you receive any misinformation.
4. The best way to enroll in a new plan is to call 1-800-MEDICARE.
Enrolling directly through Medicare is the safest way to protect yourself if there are any enrollment issues. You can also contact your State Health Insurance Assistance Program (SHIP) for help understanding your options and navigating changes.
5. If you choose a new Medicare Advantage plan during open enrollment and are dissatisfied with it after it becomes effective January 1, you can make changes during the Medicare Advantage Open Enrollment Period (January 1–March 31).
During this time, you can switch to a different Medicare Advantage plan or switch from Medicare Advantage to Original Medicare with a Part D prescription drug plan (with the same Medigap rules as above).
6. Understand the difference between Fall Open Enrollment and Open Enrollment for the state or federal Marketplaces.
The federal Marketplaces (also called Exchanges) have annual open enrollment periods for people who are uninsured or underinsured. This period may overlap with Fall Open Enrollment, but the Marketplaces are not meant for people with or eligible for Medicare. If you have or are eligible for Medicare, use the Fall Open Enrollment Period (October 15–December 7) to make changes to your Medicare coverage. As you consider your Medicare choices and the changes ahead, it’s wise to consult with a trusted financial professional who can help you understand how different plans may impact your overall financial strategy. Taking the time to discuss your options with an expert ensures you make informed decisions that support both your health needs and your long-term financial goals. Don’t hesitate to reach out and schedule a conversation to review your coverage and secure the best plan for your circumstances.
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