Medicare Open Enrollment Begins October 15: Are You Ready?

Medicare Open Enrollment begins October 15 and continues through December 7 each year. During this period, people with Medicare can review their current health and prescription drug coverage and make changes for the following year. Any changes made during Open Enrollment generally take effect January 1.

Even when you are satisfied with your current coverage, it is important to review your plan each year. Medicare Advantage and Part D prescription drug plans can change their premiums, provider networks, prescription coverage, deductibles, copays, and other out-of-pocket costs. A plan that worked well for you this year may not provide the same coverage or value next year.

Start With Your Annual Notice of Change

Your Medicare Advantage or Part D plan should send you an Annual Notice of Change before Open Enrollment begins. This document explains how your coverage and costs will change for the coming year.

Review it carefully and look for changes to your monthly premium, deductible, copays, coinsurance, provider network, pharmacy network, prescription drug list, and plan benefits. Pay particular attention to any services or medications you use regularly.

Do not assume that your coverage will remain the same simply because you stay enrolled in the same plan.

Update Your Prescription List

Prescription coverage is one of the most important areas to review during Medicare Open Enrollment. Make a current list of every medication you take, including the name, dosage, frequency, and preferred pharmacy.

Confirm that each prescription will remain covered next year and check whether its pricing tier or coverage requirements are changing. A medication may still be included in your plan but move to a different tier, resulting in a higher cost.

It is also helpful to compare pharmacy options. Some plans have preferred pharmacies that may offer lower prescription costs than other participating locations.

Confirm Your Doctors and Providers

People enrolled in Medicare Advantage should confirm that their doctors, specialists, hospitals, and other preferred providers will remain in the plan’s network next year.

Provider networks can change from year to year. Checking before December 7 may help you avoid discovering later that an important provider is no longer participating in your plan.

When reviewing a Medicare Advantage plan, consider the providers you currently see as well as specialists, hospitals, or facilities you may reasonably need during the coming year.

Look Beyond the Monthly Premium

A low monthly premium does not necessarily mean a plan will have the lowest overall cost. Compare the complete financial picture, including deductibles, prescription costs, office visit copays, specialist copays, hospital costs, and the plan’s annual out-of-pocket maximum.

Think about the care you typically use throughout the year. Someone who sees several specialists or takes multiple prescriptions may evaluate a plan differently than someone who uses very few medical services.

The goal is not simply to find the lowest premium. It is to understand what the plan may cost based on your personal health care needs.

Understand What You Can Change

During Medicare Open Enrollment, eligible Medicare beneficiaries may be able to switch Medicare Advantage plans, join or change a Medicare Part D prescription drug plan, move from Original Medicare to Medicare Advantage, or return from Medicare Advantage to Original Medicare. The appropriate options depend on your current coverage and individual circumstances.

Medicare Open Enrollment is different from the Medicare Advantage Open Enrollment Period that runs from January 1 through March 31. The fall enrollment period beginning October 15 offers broader opportunities to review and change Medicare health and prescription drug coverage.

Do Not Wait Until December 7

Comparing coverage can take time, especially when you need to confirm prescriptions, pharmacies, providers, benefits, and total costs. Starting early gives you time to ask questions and make an informed decision without feeling rushed.

Medicare Open Enrollment closes December 7. Plans must receive enrollment requests by the deadline for changes to generally begin January 1.

Washington residents can also receive free, unbiased, and confidential Medicare assistance through the Statewide Health Insurance Benefits Advisors program, commonly known as SHIBA. SHIBA volunteers can help people understand Medicare, assess their coverage needs, and explore available enrollment resources.

Before Open Enrollment begins, gather your current plan information, prescription list, preferred pharmacies, providers, and recent health care costs. A little preparation now can make it easier to choose coverage that supports your needs in the year ahead.

Medicare Open Enrollment runs from October 15 through December 7. Start your review early and reach out to the Maddock & Associates Medicare team if you need help understanding your options.

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