[Last updated September 19, 2025]

An older adult man and woman sit at their kitchen table looking at a tablet. There is a coffee mug in front of the man.
Making changes to your Medicare plan during the open enrollment period can help you get the right coverage for your senior care needs. Photo Credit: iStock.com/pixdeluxe

Choosing the right Medicare plan can make a big difference in both the quality of your care and how much you pay for it. As health and financial situations change, though, older adults may wish to make some changes to their coverage options. Fortunately, Medicare gives you a chance each year to review your current plan and make changes if your needs or the plan itself has changed. This opportunity is called the Medicare open enrollment period. Here, we’ll go over the details of Medicare open enrollment, including what it is, when it takes place, and the kinds of changes you can make.

What is the Medicare open enrollment period?

The Medicare open enrollment period, also known as the annual enrollment period (AEP) or annual coordinated election period, is a federally mandated time frame when eligible Medicare beneficiaries can modify their health care coverage. This period ensures seniors have regular opportunities to adapt their plans as their health needs and financial situations change.

Some red flags that signal you may need a plan change include:

  • Your doctors are leaving your plan’s network.
  • Your prescription medications are no longer covered.
  • Premiums have increased beyond your budget.
  • You’re frequently paying out-of-network costs.
  • Delays from prior authorization requirements are affecting your health care.

When is the Medicare open enrollment period?

Medicare open enrollment runs from October 15 through December 7 each year. This annual enrollment period gives Medicare participants a seven-week window to evaluate their current plans and make necessary adjustments. All changes made during this period become effective on January 1.

Who can make changes during Medicare open enrollment?

Individuals already enrolled in Medicare can make changes during the annual open enrollment period. Eligible beneficiaries include those with:

New Medicare beneficiaries must use different enrollment periods.

Medicare plan switches you can make during the open enrollment period

Here are the types of changes you can make during open enrollment:

  • From original Medicare to Medicare Advantage:
    • Switch to any Medicare Advantage plan available in your area.
    • Gain additional benefits like vision, dental, or wellness programs.
    • Gain access to bundled prescription drug coverage.
  • From Medicare Advantage to original Medicare:
    • Return to original Medicare Parts A and B.
    • Regain freedom to see any Medicare-accepting provider in the country.
    • Consider adding a Medigap policy for additional coverage.
  • Between Medicare Advantage plans:
  • Between Medicare Part D prescription drug plans:
    • Switch between existing Part D plans.
    • Enroll in your first Part D plan.
    • Drop Part D coverage (not recommended without other creditable coverage, as you risk future late-enrollment penalties).

Why should you review your Medicare plan during the open enrollment period?

You should review your Medicare plan during open enrollment because the insurers offering Medicare Advantage and Part D prescription drug plans change their plans annually. You also should review your plan because your needs (whether health or financial) may have evolved.

 Your insurer may have changed the following from 2025 to 2026:

  • Cost adjustments:
    • Monthly premiums.
    • Annual deductibles.
    • Copayments and coinsurance.
    • Out-of-pocket maximums.
  • Network modifications:
    • Doctor and specialist availability.
    • Hospital network changes.
    • Pharmacy network updates.
    • Geographic coverage areas.
  • Benefit changes:
    • Additions or eliminations of covered services.
    • Prior authorization requirements.
    • Referral policies.
    • Additional benefits (dental, vision, hearing aids).
  • Prescription drug coverage:
    • Updates to the formulary (covered medications list).
    • Tier changes affecting what you’ll pay for drugs.
    • Preferred pharmacy networks.

There are also some personal factors to consider:

  • Health status changes: New diagnoses, medications, or treatment needs.
  • Financial situation: Income changes affecting plan affordability.
  • Geographic moves: Different plan availability in new locations.
  • Provider preferences: Desire to keep specific doctors or hospitals.

Do you need to change your Medigap (Medicare supplement insurance) plan during open enrollment?

Generally, you don’t need to change your Medigap plan once you select one. Medigap policies are standardized and typically don’t require annual review like Medicare Advantage or Part D plans. However, you may consider a policy change if:

  • Your premium has increased significantly.
  • You’ve moved to a new state.
  • Your financial situation has changed.
  • You want different coverage levels.
  • You want to change insurers.

Also, if you’re switching from Medicare Advantage back to original Medicare during the open enrollment period, you might want to purchase Medigap coverage. This process may not be so easy because full access to any Medigap policy is only guaranteed during specific periods. These include your initial six-month Medigap open enrollment period (starting when you’re 65+ and have Part B) and if you return to original Medicare within a year of signing up for Medicare Advantage upon turning 65.

If you decide to change or add a Medigap plan outside those or other specific windows, remember that:

  • Applications likely require medical underwriting (except during guaranteed issue periods).
  • Approval depends on health status and medical history.
  • Higher premiums may apply based on age and health.
  • Coverage of preexisting conditions may be denied or delayed.

It’s essential not to cancel your current Medigap plan until you’re approved for a new one.

The Medicare Advantage open enrollment period alternative

If you miss the main open enrollment period, Medicare Advantage beneficiaries have a second chance during the Medicare Advantage open enrollment period. Here are the details:

  • Dates: January 1 through March 31.
  • Allowed changes: Switch Medicare Advantage plans or return to original Medicare.
  • Coverage effective: The month following your enrollment.

How to make the most of Medicare open enrollment 2026

Here is a step-by-step review process:

1.    Gather current plan information:

  • Review your annual notice of change (ANOC), which details any changes to your plan.
  • Check your evidence of coverage (EOC) document, which provides details about the plan’s coverage, how much you pay, and more.
  • List your current medications and dosages.

2.    Get help from free Medicare resources:

3.    Compare plans systematically:

  • Total annual costs (premiums plus out-of-pocket expenses).
  • Provider networks and preferred doctors.
  • Prescription drug coverage and costs.
  • Additional benefits that matter to you, such as vision or dental coverage.

4.    Make informed decisions:

  • Consider both current and potential future needs.
  • Factor in plan stability and insurer reputation.
  • Consult with licensed insurance agents for professional guidance on complex situations.

Take action before the deadline

Whether you’re satisfied with your current plan or considering changes, reviewing your options ensures you’ll have appropriate coverage starting January 1. Start your review early in the open enrollment period so you can do a thorough comparison and get any help you need in your decision-making.

Remember, if you miss the December 7 deadline, you may need to wait until the following year to make changes, unless you qualify for a special enrollment period due to specific life events. Your future health and financial well-being depend on making informed choices during this crucial annual opportunity.