Editor's Note: This story originally appeared on Boldin.
Tis the season … No, even though Christmas decorations are crowding store shelves, it is not quite time for the winter holidays.
However, if you are 65 or over, it is the season of a special kind of shopping. The Medicare Open Enrollment season is upon us and will last from Oct. 15 to Dec. 7.
Now is the time to assess your current coverage and shop around for perhaps a better deal or a plan more suitable to your current health needs.
Here are tips for getting the best coverage and care from the Medicare open enrollment period.
1. Know the Open Enrollment Rules
Medicare’s open enrollment is a period of time every year when you can:
- Change from Medicare Parts A and B (Original Medicare) to a Part C (private Medicare Advantage) plan
- Change from Medicare Advantage back to Original Medicare
- Join, drop or switch a Part D prescription drug plan
- Switch Medicare Advantage plans
You are never locked into your Medicare coverage for more than a year, and it is important to assess annually for better insurance at a lower cost.
2. Find Out How Your Existing Plan Has Changed
Not everyone knows this, but Medicare plans can — and do — change. So, the first step is to find out what is new with your existing coverage.
If there are changes, your plan should have sent you a “Plan Annual Notice of Change” (ANOC) in September. If you think you missed it, call your insurer and ask for the annual notice of change.
Pay particular attention to:
- The list of drugs that the plan will cover in the next year
- How much those drugs will cost
- What the premium will be in 2026
- What percentage the plan will pay for different types of medical expenses
3. Find Out What Plans Your Preferred Doctors Will Accept in 2026
You may want to call your doctors’ offices and ask to speak with the billing departments. They should be able to tell you which plans they will be accepted in 2026.
If they are dropping your existing plan, then you will want to see if any of the other plans are affordable for you.
4. Assess If Your Existing Plan Is Still a Good Match for Your Health Needs
Once you know what your existing Medicare supplemental plan will cover in 2026, you should compare how well that matches your current and anticipated needs.
Will your existing plan still cover the medications you take? Has your health changed, and do you now have different needs?
5. Understand New Drug Plans (and Impact on Other Coverage)
For the prescription drug side (Part D), while some premiums are expected to hold steady, there are structural changes that could lead to higher cost burdens for certain beneficiaries, such as changes to the out-of-pocket cap increasing to $2,100 from $2,000.
Again, be sure to look carefully at any changes to your current coverage.
6. Compare Your Existing Plan With Alternatives
Even if your existing plan works well for you, you should still shop around to see if there is a more cost-effective option.
You can contact your State Health Insurance Assistance Program (SHIP). SHIP (sometimes called by another name) offices provide free counseling to any Medicare recipient to help people choose a Medicare plan.
You can contact Medicare at 1-800-MEDICARE or Medicare.gov. They have a Medicare plan comparison tool that may be helpful.
The Boldin Retirement Planner also enables you to estimate your lifetime medical costs for different coverage types, health conditions and premium levels.
7. Beware of Medicare Scams, and Don’t Believe All the Ads You’ll See
It is illegal for any licensed Medicare agent to make unsolicited contact with you. So, if you get a call, text, or voicemail from someone offering Medicare services, it is a scam.
Do not give out any personal information.
Also, be wary of the barrage of advertising you will likely see during this period.
8. Check Out Ratings on Plans
Once you have identified a plan or plans that may be a good fit for your particular health needs, you can look up how well those plans rate.
Medicare.gov lets you research plan quality and performance ratings.
U.S. News & World Report is also a reliable source. They evaluate all insurance companies and the plans they offer in each state. See the Best Medicare Advantage Plans and the best plans by state.
9. Cut Your Prescription Costs
Even with supplemental coverage, prescription copays can add up. To save money, discuss your concerns with your doctor. Ask if they will prescribe a less expensive alternative or a generic.
Whatever your doctor prescribes, shop around to fill your prescription. Filling the same prescription at Costco versus CVS could save a lot. Ordering a 90-day supply online may save you even more.
10. Use a Health Savings Account (HSA)
If you’re still working and are eligible to contribute to an HSA, take advantage of it.
Your contributions are made pre-tax, the money in your account grows tax-free, and you can withdraw funds from the account at any time tax-free, as long as the money is used for qualified medical expenses.
Learn more about HSAs: What they are and why they are a compelling savings option.
11. Be Proactive to Stay Healthy
If you are in good health, you’ll spend less on retirement health care costs.
Medicare offers a wide range of immunizations, preventive screenings and well-being programs for free.
12. Factor Out-of-Pocket Medical Costs Into Your Retirement Financial Plan
Out-of-pocket medical costs are one of the three biggest expenditures for most retirees. Studies have shown that the total out-of-pocket Medicare costs are higher than the total Social Security income for the average retiree.
In other words, Social Security income does not even cover what most retirees will have to spend on their health.
So, it is important to make sure that your retirement finances are prepared for this major expense.
13. Know About Your Disenrollment Period
From Jan. 1 to March 31, 2026, you can switch Medicare Advantage plans or move back to Original Medicare if you change your mind after enrollment.
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