Medicare Open Enrollment Checklist
Medicare Open Enrollment is the time each year when people with Medicare can review their current coverage and decide whether they want to make changes for the year ahead.
Are You Ready for Open Enrollment?
The Medicare Open Enrollment Period runs from October 15 through December 7. Any changes you make during this period take effect on January 1 of the following year. If you do not make changes, your current plan will generally continue into the new year, including any updated costs, coverage or benefit changes announced by your plan.
- Mid-September: Begin watching for plan materials and notices.
- October 15: Medicare Open Enrollment begins.
- December 7: Final day to submit changes for the upcoming plan year.
- January 1: New coverage begins for changes made during Open Enrollment.
1. Review Your Plan Notices
If you are enrolled in a Medicare Advantage Plan or Medicare drug plan, your plan sends an Annual Notice of Change, often called an ANOC, each fall. This notice explains changes that will take effect in January, including updates to costs, coverage, provider networks, prescription drug coverage and benefits.
- Read your Annual Notice of Change carefully.
- Compare this year’s benefits, premiums, copays and out-of-pocket costs with next year’s plan details.
- Check whether any prescriptions are moving to a different drug tier or require new restrictions.
- Confirm whether your preferred doctors, hospitals, pharmacies and specialists remain in network.
2. Consider Whether Your Current Plan Still Meets Your Needs
Even if you were happy with your plan this year, your health, prescriptions, finances or provider preferences may have changed. Open Enrollment is a good time to compare your current coverage with other available options.
Questions to Ask
- Am I happy with my current doctor and care team?
- Are my preferred doctors, specialists, hospitals and pharmacies still covered by my plan?
- Are my prescriptions still covered at a cost I can afford?
- Have my health needs changed in the past year?
- Has my financial situation changed?
- Would I prefer Original Medicare with a separate Part D plan and, if eligible, a Medicare Supplement Insurance policy?
- Do I need dental, vision, hearing, transportation, fitness or other supplemental benefits that may vary by plan?
3. Understand Your Main Medicare Coverage Options
There are two common ways people receive Medicare coverage: Original Medicare or a Medicare Advantage Plan. Your choice may affect your provider access, prescription drug coverage, monthly costs and out-of-pocket expenses.
| Coverage Option |
How It Works |
What to Review |
| Original Medicare |
Includes Part A and Part B. You can generally see any doctor or hospital that accepts Medicare. You may also choose to add a separate Part D prescription drug plan and supplemental coverage, such as Medicare Supplement Insurance, also known as Medigap. |
Part B premium, deductibles, coinsurance, Part D prescription coverage and whether a Medigap policy is available to you. |
| Medicare Advantage |
Also called Part C. These plans are offered by private companies approved by Medicare and provide Part A and Part B benefits. Many plans include Part D prescription drug coverage and may offer additional benefits. |
Provider network, hospital access, referrals, prescription coverage, prior authorization rules, monthly premium and maximum out-of-pocket costs. |
| Medicare Part D |
Helps cover prescription drug costs. Part D may be included in a Medicare Advantage Plan or purchased separately if you have Original Medicare. |
Drug formulary, pharmacy network, drug tiers, deductibles, copays and whether your medications are covered. |
Important Note About Medicare Supplement Insurance
Medicare Supplement Insurance, also called Medigap, is different from Medicare Advantage. Medigap can help pay some out-of-pocket costs under Original Medicare, such as deductibles, copayments or coinsurance.
Medigap has its own enrollment rules. In most cases, your best time to buy a Medigap policy is during your Medigap Open Enrollment Period, which is a six-month period that begins when you are 65 or older and enrolled in Medicare Part B. This period does not repeat every year like Medicare Open Enrollment. After that window, you may have fewer options or may pay more, depending on your situation and state rules.
4. Review Your Prescription Drug Coverage
Prescription drug coverage can change from year to year. A medication that was covered affordably this year may cost more next year if it moves to a different tier, requires prior authorization or is no longer covered by your plan.
- Make a current list of all prescription medications, including dosage and frequency.
- Check whether each medication is covered by your current plan for the upcoming year.
- Review whether your preferred pharmacy is still in network.
- Compare estimated yearly drug costs, not just monthly premiums.
5. Before You Make a Change
Before switching plans, take time to confirm the details that matter most to your care and budget.
- Confirm that your doctors and hospitals accept the plan.
- Check whether you need referrals to see specialists.
- Review prior authorization requirements for medications, procedures or services.
- Compare total estimated costs, including premiums, deductibles, copays, coinsurance and maximum out-of-pocket limits.
- Ask whether your current care team or upcoming treatments could be affected by a plan change.
Need Help Reviewing Your Options?
You do not have to compare plans alone. Medicare offers plan comparison tools, and California residents can also contact the Health Insurance Counseling and Advocacy Program, known as HICAP, for free, confidential Medicare counseling.
Disclaimer
This information is for general education only and should not be considered insurance, financial or legal advice. Medicare coverage, costs and plan availability may change each year. Review official Medicare materials and contact Medicare, HICAP or a licensed insurance professional before making coverage decisions.
