The Medicare fall open enrollment period, also called the annual election period (AEP) starts on October 15 and ends on December 7. During this time, current Medicare enrollees can review their plan selection and decide whether or not to change plans for the following year. During this year’s AEP, be on the lookout for changes to existing benefits, as well as benefits that could help you stay healthy and on budget in the following year.
Medicare Enrollment Decisions
During AEP you can:
- Switch from one Medicare Advantage plan to a different Medicare Advantage plan
- Switch from a Medicare Advantage plan back to Original Medicare
- Switch from Original Medicare to a Medicare Advantage plan
- Switch from a Medicare Advantage plan with drug coverage to one without drug coverage
- Switch from a Medicare Advantage plan without to drug coverage to one with drug coverage
- Join a Medicare Prescription Drug plan, drop a Medicare Prescription Drug plan or switch from one Medicare Prescription Drug plan to another Medicare Prescription Drug plan
Advantage Plans Change Every Year
If you have a Medicare Advantage Plan your insurer will send you an Annual Notice of Change (ANOC) Letter every September. This will notify you of any changes to your plan for the upcoming year. It’s important to read it carefully. If any changes impact you negatively you can look for a new plan that better suits your needs during AEP.
Common Medicare Advantage Benefits to Review During AEP
Supplemental Benefits
Many Medicare beneficiaries choose a Medicare Advantage plan because of the extra benefits they offer that are not included with Original Medicare. Since Medicare Advantage plans are offered by private insurance companies, the benefits and costs can vary from plan to plan. Most plans include coverage for dental, hearing, and vision benefits. Some plans cover acupuncture, massage, and chiropractic care. Many plans offer extras such as gym memberships, over the counter allowance, home delivered meals after a hospital stay, transportation to medical appointments and more.
In 2025 plans began to trim some of these supplemental benefits in order to better manage costs. Be sure to check your ANOC this fall to see if there are any changes for 2026 to the benefits that are important to you.
Out of Pocket Costs
It’s important to make sure your coverage is still affordable. Check any changes to your out of pocket costs such as the monthly premium payment, any deductibles, copays, and coinsurances for both medical and prescription coverage.
Prescription Benefits
Whether you’re getting prescription coverage through a Medicare Advantage plan or a Medicare Part D plan, it’s important to check every year for any changes to the drug formulary. Confirm that your medications are still on the formulary and check to see if there have been any changes to the tier they fall on as this will determine what you pay. Each insurer’s formulary is different. If your medication is no longer covered or has become more expensive, another insurer might offer better options.
Other Part D News to Review for 2026
- $35 insulin copays will remain the same
- The $2,000 RX out of pocket max will increase to $2,100
- The Prescription Payment Plan is still available to help you manage your Part D costs by spreading them out over the year. If you are already enrolled, you will automatically be re-enrolled for 2026.\
Provider Networks
Verify that all your preferred healthcare providers and pharmacies are still in the plan’s network.
Changes to Your Lifestyle or Health
Sometimes you may experience changes that necessitate changing healthcare plans. This could include:
- Changes to your lifestyle, including traveling more frequently out of the area
- Changes to your budget
- Newly diagnosed health concerns
AEP is the ideal time to evaluate your current healthcare plan and how it is working for you. Read your ANOC as it offers important information for any changes being made for 2026. If finding the right Medicare coverage feels overwhelming, a local, licensed Medicare agent can help you compare your options and find the right plan for your needs.
