Medicare Open Enrollment runs from Oct. 15 through Dec. 7 each year. During this period, you can compare your current coverage with other options and make changes to your Medicare Advantage or Part D prescription drug coverage for the coming year. Changes take effect Jan. 1.
“Even if you’re satisfied with your current Medicare plan, it’s still a good idea to review it every year,” explained Ryan Ramsey, NCOA Associate Director of Health Coverage and Benefits. “That’s because premiums, out-of-pocket costs, covered medications, provider networks, benefits, and coverage rules can all look different from one year to the next.”
Here are five things to check during Medicare Open Enrollment to see if the plan you’re in (or the plan you’re looking to join) is the right one for you.
A 5-Step Checklist for Medicare Open Enrollment
| Step | What to check | Why it matters |
|---|---|---|
| 1. Read your Medicare mail | Review your ANOC and any notices from Medicare, Social Security, or your plan. | Your coverage, costs, or Part D LIS/Extra Help benefits may change—or your plan may end. |
| 2. Confirm your providers | Make sure you doctors, specialists, and hospitals will accept your plan in 2027. | Medicare Advantage provider networks can change each year. |
| 3. Review your drug coverage | Check that each medication is covered, what tier it's on, and if restrictions apply. | Formulary changes can affect access and cost. |
| 4. Check your pharmacy | Compare prices at preferred, in-network, and mail-order pharmacies. | The same medication may cost less at certain pharmacies. |
| 5. Get an idea of your total estimated costs | Compare premiums, deductibles, copays, coinsurance, and out-of-pocket limits. | A low montly premium doesn't always mean a lower total cost. |
Why should I review my Medicare plan every year?
Medicare Advantage and Part D (prescription drug) plans can change their costs, covered medications, provider networks, benefits, pharmacies, and coverage rules each year. Your health needs and prescriptions may change, too. Reviewing your coverage during Medicare Open Enrollment can help you make sure your plan still fits your needs and budget—and avoid unexpected out-of-pocket costs in the coming year.
Unless you qualify for a Special Enrollment Period, Open Enrollment is the only time you can join or switch health (Medicare Advantage) and prescription drug (Part D) plans for the coming year.
If you’ve been affected by a recent natural disaster, your Medicare open enrollment may extend to Dec. 31. To request an extended enrollment period, call 1-800-MEDICARE or contact your health insurance company or drug plan directly.
How to review your Medicare plan: 5 simple steps
1. Check your mailbox
If you’ve been ignoring the marketing mail from plans looking to get you to change, make sure you don’t overlook any official mailings that come directly from Medicare or Social Security. Learn how to tell the difference.
For example, if your plan decided not to renew its contract with Medicare or continue to serve your area, you should receive a notice in October and will get another reminder in November to select a new option.
Are you receiving the Part D Low Income Subsidy (LIS), also known as Extra Help, to pay for your prescriptions? If so, you may receive information about your continued eligibility for this benefit, changes in copayments at the pharmacy, or a notice about selecting a new plan if your plan is being terminated at the end of the year.
If you’re currently enrolled in a Medicare Advantage or Part D plan, you should receive an Annual Notice of Change (ANOC) from your plan in September. Be sure to read the ANOC closely, as it outlines any changes to your costs and coverage in the coming year.
2. Check with your doctors and specialists
Medicare Advantage plans may limit members to using specific providers. If you want to continue seeing your doctor and any specialists, be sure to check that they are still in your Medicare plan’s network. Medicare Advantage plans are required by the Centers for Medicare & Medicaid Services (CMS) to keep their online provider directories updated. People with original Medicare usually only need to ensure their providers are still accepting Medicare assignment.
3. Check the drug formulary
Each Medicare plan that covers prescription drugs has its own formulary, or list of covered medications. In addition, most formularies have tiers that affect how much you pay for your drugs at the pharmacy.
Medicare Open Enrollment is the time to check:
- Whether the prescriptions you take are on the plan’s formulary
- What tier they fall under (and therefore what your copayment is)
- Whether the plan places any restrictions on how you can get your medication, such as quantity limits or prior authorization from your provider
4. Check with your pharmacy
Some plans have negotiated with specific pharmacies to offer discounts to plan members who fill their prescriptions there. If you have a preferred pharmacy, or like to receive your medications by mail, be sure to compare how much you’ll pay for those options when shopping for plans.
5. Check how much Medicare will cost you in 2027
While Medicare health and drug plan premiums may increase slightly in 2027, you should look beyond premiums to determine actual out-of-pocket costs. Be sure to check for the deductible, copayments, and learn more about Medicare will cover for prescription costs.
Where can I get free help reviewing my Medicare plan?
If you’re confused about Medicare and need a place to start learning about your coverage options, you can get help and compare plans by:
- Using the Medicare Plan Finder online
- Calling 1-800-MEDICARE
- Contacting your local State Health Insurance Assistance Program (SHIP), which is federally funded to provide free, objective assistance to people with Medicare and their families.
- Explore guides from NCOA:
Frequently asked questions (FAQ)
How do I know if my Medicare plan is changing?
Review the Annual Notice of Change (ANOC) your Medicare Advantage or Part D plan sends each fall. It explains changes to costs, benefits, covered medications, provider networks, pharmacies, and coverage rules for the coming year. You can also contact your plan directly if anything is unclear.
How do I check a Medicare plan’s drug list?
Look at the plan’s formulary, or list of covered medications, on the insurer’s website or use the Medicare Plan Finder. Check each drug’s tier, cost, pharmacy restrictions, and requirements such as prior authorization, step therapy, or quantity limits.
How do I compare Medicare plans?
Use the Medicare Plan Finder to compare coverage, estimated drug and health care costs, provider networks, pharmacies, benefits, and quality ratings. Consider total yearly costs (not just the monthly premium) and confirm important details directly with the plan. For free, unbiased help, contact your local State Health Insurance Assistance Program (SHIP).
