The annual Medicare open enrollment period is currently underway, allowing millions of U.S. seniors to select or change their health insurance coverage for the upcoming year. The enrollment window, which began on Oct. 15, is scheduled to close on Dec. 7. Experts from KFF and Reliance Medicare Advisors state that even those satisfied with their current plans should review their options, as premiums, drug coverage, and provider networks frequently change.
Most participants in Medicare Advantage or Part D prescription drug plans should have received an "Annual Notice of Change" in September. This document outlines modifications to costs and coverage for the following year. Jessica Rivkin of Reliance Medicare Advisors noted that individuals should verify their current plan even if they did not receive a notice. For those needing assistance, the Centers for Medicare & Medicaid Services (CMS) offers a "Plan Finder" tool and a helpline at 1-800-Medicare.
A primary choice for enrollees is between traditional Medicare and Medicare Advantage. Traditional Medicare often requires separate selections for Part D drug plans and Medigap, which is private insurance used to cover out-of-pocket costs. Medicare Advantage plans, managed by private insurers, provide coverage in a single plan but often impose stricter requirements, such as limiting patients to in-network providers or charging higher rates for out-of-network care.
This period affects millions of Americans enrolled in Medicare, the federal health insurance program for people 65 or older and younger people with disabilities. Because health plans are updated annually, a person could see a change in their yearly out-of-pocket costs or find that a physician is no longer in their network. For example, Alex Cottrill of KFF noted that those who switch from Medicare Advantage back to traditional Medicare later in life may face higher Medigap premiums due to their age or pre-existing conditions compared to those who started with traditional Medicare and Medigap from the outset.
The change for seniors will begin on Jan. 1, 2027, when new coverage takes effect. Small changes in a plan's formulary—the list of covered drugs—could mean a specific medication is no longer covered or has moved to a higher cost tier. Those who miss the Dec. 7 deadline generally cannot change their coverage for the rest of the year, though Medicare Advantage users have a separate window from Jan. 1 to March 31 to switch plans or return to original Medicare.
Decisions regarding Medigap are significant because individuals who switch from Medicare Advantage back to traditional Medicare later may be charged higher premiums for Medigap coverage due to their age or pre-existing conditions. After the Dec. 7 deadline, the next major milestone is Jan. 1, 2027, when new plans become active. Special enrollment periods remain available for those with specific life events, such as moving or losing existing coverage. Experts recommend using the CMS Plan Finder tool or consulting State Health Insurance Assistance Programs for tailored counseling.