Medicare Open Enrollment 2026: What to Review Before December 7
By Brian Sesniak, Founder & CEO, Rising Tides Benefits Group
Medicare Open Enrollment runs from October 15 to December 7, 2026. It's your once-a-year chance to switch Medicare Advantage or Part D drug plans, or move between Original Medicare and Medicare Advantage. Changes take effect January 1, 2027. Even if you're happy with your plan, take 30 minutes to review it, because plans change every year.
Why I Ask Every Client to Review Their Plan Each Fall
Every fall, I hear some version of the same thing: "My plan worked fine this year, so I'll just keep it." I understand. Nobody wants to spend an afternoon reading insurance paperwork.
But Medicare plans aren't set in stone. Premiums, copays, drug lists and doctor networks can all change from one year to the next. Your health can change too. A plan that fit you perfectly last January might not fit next January, and you won't find out until you're at the pharmacy counter or the doctor's office.
I've seen firsthand what it means to have the right coverage when life turns upside down. A little preparation now can save you a lot of stress later. So here's the simple checkup I walk my clients through every year.
Key Medicare Dates for 2026 and 2027
October 15, 2026: Medicare Open Enrollment begins
December 7, 2026: Last day to make changes. Your new plan must receive your request by this date
January 1, 2027: Any changes you make take effect
January 1 to March 31, 2027: If you're in a Medicare Advantage plan, you get one more chance to switch Medicare Advantage plans or return to Original Medicare
What You Can Change During Open Enrollment
During these weeks, you can:
Switch from one Medicare Advantage plan to another
Move from Original Medicare to a Medicare Advantage plan, or from Medicare Advantage back to Original Medicare
Join, switch or drop a Part D prescription drug plan
If you don't make a change, most plans renew automatically. That's convenient, but it also means any changes to your plan happen whether you've looked at them or not.
Your 5-Step Medicare Checkup
1. Read your Annual Notice of Change
If you're in a Medicare Advantage or Part D plan, your plan should have sent you an Annual Notice of Change, usually by the end of September. It lists everything that's changing for next year. If you can't find it, call your plan or give us a call and we'll help you track it down.
2. Check your doctors and hospitals
If your plan has a network, confirm that your doctors, specialists and preferred hospitals will still be in it next year. Networks change more often than people expect.
3. Review your prescriptions
Make a list of every medication you take, with the dose. Check that each one is still covered, which tier it's on, and whether your pharmacy is still a preferred pharmacy. A drug that moves to a higher tier can raise your costs quickly.
4. Look at your total cost, not just the premium
A low monthly premium is nice, but it's only part of the picture. Add up what you'd likely pay over the year in premiums, deductibles, copays and drug costs. Sometimes the plan with the higher premium costs less overall.
5. Think about the year ahead
Do you have a surgery or new treatment coming up? Do you spend part of the year outside Florida or travel often? Are you seeing a new specialist? Your plan should fit the year you're about to have, not just the one you just had.
What's New for 2027
A few Medicare changes are worth knowing about this year:
Higher Part D drug cost cap. The most you'll pay out of pocket for covered Part D drugs in 2027 is $2,400, up from $2,100 in 2026. Once you reach it, you pay nothing more for covered drugs for the rest of the year.
Higher maximum Part D deductible. Drug plans can charge a deductible of up to $700 in 2027, up from $615. Many plans charge less, which is one more reason to compare.
Stand-alone drug plan premiums may change. A temporary federal program that helped hold down stand-alone Part D premiums ended after 2026, so check your 2027 premium carefully.
Insulin stays capped. Covered insulin under Part D still costs no more than $35 for a month's supply.
Part B costs. CMS typically announces next year's Part B premium and deductible in the fall. For 2026, the standard Part B premium is $202.90 a month.
What About Medicare Supplement (Medigap)?
Open Enrollment doesn't apply to Medicare Supplement plans in the same way. You can apply to change your Medigap plan at other times of year, but in most cases outside your initial Medigap enrollment period, insurance companies can ask health questions and may decline an application. If you're thinking about switching from a Medigap plan to Medicare Advantage, or the other way around, talk it through before you make a move, because it can be hard to go back.
Common Mistakes to Avoid
Letting your plan renew without looking. Most of the surprises I help clients sort out in January could have been caught in October.
Choosing on premium alone. Look at your total yearly cost.
Waiting until the last week. December 7 comes fast, especially around the holidays. Start early so you have time to ask questions.
Giving your Medicare number to unexpected callers. Medicare won't call you out of the blue to sell you a plan. If someone calls unexpectedly asking for your Medicare number, Social Security number or bank information, hang up.
You Don't Have to Do This Alone
Medicare can feel overwhelming, but you don't have to figure it out by yourself. You can compare plans at Medicare.gov, call 1-800-MEDICARE, or get free counseling through SHINE, Florida's State Health Insurance Assistance Program, at 1-800-963-5337.
You can also sit down with us. At Rising Tides, we'll review your current coverage, check your doctors and prescriptions, and compare your options in plain English, at no cost to you. We're right here in St. Augustine and help clients across Northeast Florida by phone, video or in person.
Questions About Your Medicare Plan?
Not a government website. Rising Tides Benefits Group is not affiliated with, endorsed by, or connected to the Centers for Medicare & Medicaid Services (CMS), the U.S. Department of Health and Human Services, or any federal or state government agency. We do not offer every product available in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. We are licensed, independent insurance broker. We represent multiple insurance carriers and may receive compensation from the carriers whose plans we sell. This does not affect the cost of your plan.
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Serving areas across Florida, Local to St Augustine, Duval, Clay, and Flagler Counties.
Not a government website. Rising Tides Benefits Group is not affiliated with, endorsed by, or connected to the Centers for Medicare & Medicaid Services (CMS), the U.S. Department of Health and Human Services, or any federal or state government agency. We do not offer every product available in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. We are licensed, independent insurance broker. We represent multiple insurance carriers and may receive compensation from the carriers whose plans we sell. This does not affect the cost of your plan.