Medicare Enrollment Is Open: What You Can Change Before December 7

The window and why the date matters

Medicare's Annual Enrollment Period runs October 15 to December 7 each year, according to Medicare.gov. From this issue's October 27 publish date, that leaves about six weeks. The date matters because coverage changes made during this window generally take effect January 1 of the following year. Miss December 7 and, in most cases, you stay with what you have for next year, even if your plan's costs or drug list changed. That is why this period deserves a deliberate look rather than a shrug. Plans are not static. Premiums, deductibles, copays, pharmacy networks, and the list of covered drugs can all shift from one year to the next, and your plan keeps renewing automatically unless you act. Doing nothing is a choice, and it is a choice to accept whatever your plan decided for next year. The rest of this issue walks through what you can change, what you cannot, and how to compare plans with your own paperwork in hand.

What you can change

During the Annual Enrollment Period you can make several moves. If you have Original Medicare, you can join a Medicare Advantage plan. If you are in a Medicare Advantage plan, you can switch to a different one, or return to Original Medicare. You can also join, drop, or switch a Medicare Part D prescription drug plan. Medicare.gov's Plan Finder lets you compare available options by entering your ZIP code and your actual medications. Whatever you pick generally starts January 1. One practical point: if you leave Medicare Advantage for Original Medicare and want drug coverage, you will typically need a standalone Part D plan, so treat those as a pair rather than separate decisions. Also remember that your choice replaces the old one. You are not adding a second plan on top. Your Medicare Advantage plan, if you have one, bundles hospital and medical coverage and often drug coverage, so switching can change which doctors and hospitals are in your network.

What this window does not do

Just as important is what this window does not do. It does not let you change coverage retroactively, and it does not change anything before January 1 in most cases. The biggest catch involves Medigap, the supplemental policies sold alongside Original Medicare. If you move from Medicare Advantage back to Original Medicare and want a Medigap policy, insurers in many states can review your health history and may charge more or decline you. Ask about that before you drop your plan, not after. Ask each plan for the details in writing. The window also does not let you keep a drug or doctor that a new plan does not cover. Network and drug list rules belong to each plan. Other special enrollment situations exist, such as moving out of your plan's area or losing other coverage, but they have their own rules and deadlines, so do not plan around them as a backup. Treat December 7 as the real deadline, not a suggestion.

A worked example: the cheaper premium that costs more

Here is a hypothetical to show the arithmetic. Suppose your Part D plan charges $35 a month this year, and the Annual Notice of Change says it will be $48 next year. That is $13 more a month, or $156 more a year. Tempting to switch. Plan Finder shows another plan at $40 a month. Now add your medications. Say you take one brand drug that costs $20 a month on your current plan but $45 on the cheaper-premium plan. Stay: $48 times 12 is $576 in premiums, plus $20 times 12 is $240 in copays, for $816. Switch: $40 times 12 is $480, plus $45 times 12 is $540, for $1,020. Staying costs $204 less, even with the bigger premium increase. Also add any deductible the plan charges before coverage starts. These numbers are made up, but the method is real: multiply every monthly cost by twelve, include every drug you take, and compare totals rather than premiums alone.

What people get wrong

Several mistakes cost real money. The first is ignoring the Annual Notice of Change. Plans must send it by September 30, per CMS, and it spells out next year's premiums, deductibles, copays, and coverage changes. If yours is gone, your plan can resend it or you can look up the plan's 2027 details in Plan Finder. The second mistake is comparing premiums only, as the example showed. The third is assuming your drugs, pharmacy, and doctors carry over, when drug lists and networks change every year. The fourth is trusting a phone call or mailer. The Federal Trade Commission and the HHS Office of Inspector General warn about scammers who push people to switch plans or hand over a Medicare number. Medicare does not call to sell you a plan, so hang up and go to Medicare.gov yourself. The fifth is waiting until the last days of the window, when a single missed detail leaves no time to fix it.

How to check your own situation

Set aside an hour with these items. First, find your Annual Notice of Change and read the pages on premium, deductible, drug tiers, and any drugs removed. Keep the notice and your list together. Second, pull your current medication list with exact names, doses, and how often you fill them. Third, write down your doctors, hospitals, and preferred pharmacy. Fourth, open Medicare.gov Plan Finder, enter your ZIP code and medications, and compare total estimated yearly cost, not only the premium. Fifth, call each candidate plan or check its provider directory to confirm your doctors are in the network. Sixth, if the choices feel tangled, your State Health Insurance Assistance Program offers free, unbiased counseling; find yours through shiphelp.org. Finally, write down your decision and confirm it afterward by checking that you received a new plan's enrollment confirmation. The one takeaway: before December 7, compare total yearly costs for your actual drugs and doctors, because staying put is also a decision with a price.

For general education only. Not legal, tax, or financial advice, and not a recommendation of any specific Medicare plan. Plan availability, costs, and rules vary by location and individual circumstances; the dollar figures in the worked example are hypothetical. Confirm details with Medicare.gov, your plan, or a licensed professional or your State Health Insurance Assistance Program (SHIP) before making changes.