Medicare Open Enrollment Decisions – Should I Change My Medicare Coverage During Open Enrollment?

2026 · SHOULD I CHANGE MY MEDICARE COVERAGE
DURING OPEN ENROLLMENT?
Have your Medicare plan costs and/or health care costs recently increased or are you paying for coverage that you don’t use?Consider seeking a more affordable plan that meets your needs. Compare premiums, copays, and out-of-pocket maximums.Consider seeking a new plan that meets your service needs. If you expect dental, hearing, or vision expenses, consider a Medicare Advantage plan.Consider seeking a new plan that allows affordable access to your preferred providers (including out-of-state specialists, if any) and/or essential prescription drugs. Compare networks and drug formularies and tiers.Even if your cost, coverage, and service needs haven't changed, consider giving your plan and alternatives an annual review.Has your plan’s coverage of services, or have your needs for services, recently changed?Are you currently enrolled in Original Medicare (Part A and Part B)?You can change from Original Medicare to a Medicare Advantage plan between October 15 and December 7.You can drop your Medicare drug plan or change to another Medicare drug plan between October 15 and December 7.If you require access to certain providers, services, and/or prescription drugs, ensure that changes you make will meet your specific needs.Any changes you make during Open Enrollment will go into effect on January 1.If you are enrolled in a Medicare Supplement (Medigap) plan, you may make changes at any time, but you might be subject to underwriting and denied coverage.Do you have a Medicare prescription drug plan (Part D)?You can join a Medicare drug plan between October 15 and December 7. This could limit any late enrollment penalties (from coverage gaps) you may be subject to.You can change to a new Medicare Advantage plan (adding or removing drug coverage) or return to Original Medicare during two Open Enrollment Periods, between October 15 and December 7, and between January 1 and March 31.Are you currently enrolled in a Medicare Advantage plan (Part C)?You must first enroll during your Initial Enrollment Period (a 7-month window including the month that you turn 65 and the 3 months before and after), the General Enrollment Period (January 1 - March 31), or a Special Enrollment Period, if applicable.Do you require access to certain hospitals, physicians, and/or prescription drugs that are not covered under your current plan? Could there be other compelling reasons to update your coverage (e.g., convenience, quality, travel plans, etc.)?Consider maintaining your existing coverage for another year.YesNoYesNoYesNoYesNoYesNoYesNoYesNoSTART HERE
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Joanne Burke, CFP®, CPA/PFS
705 Birch ST SW Vienna, VA 22180-6308
Joanne@Birchstreetadvisors.com | 703-319-8778 | www.Birchstreetadvisors.com