Open Enrollment Starts October 15: A Ten-Minute Checklist Before You Change Anything

Medicare open enrollment runs October 15 through December 7, 2026, and whatever you choose takes effect January 1. Before you change anything, spend ten minutes on the paperwork your plan already mailed you: the Annual Notice of Change, your drug list, your doctor list and any letter saying your plan is leaving. If nothing has gone wrong, staying put is a legitimate choice.

Every fall, two opposite mistakes happen. Some people ignore the envelope from their plan and discover in January that a drug moved to a higher tier or a specialist left the network. Others see a television ad, switch plans on impulse and find out in February that the new plan doesn’t cover the pharmacy down the street. Both mistakes come from skipping the same short review.

This checklist is built to be done in one sitting, with a pen and the mail you’ve been meaning to open. It won’t tell you which plan to pick, because that depends on your doctors, your prescriptions and your budget. It will tell you whether you have a reason to look at other plans at all, and that is the question that matters first.

The Dates, and Why the Window Is Longer Than It Feels

CMS announced on September 28 that the 2027 open enrollment period, which Medicare also calls the Annual Enrollment Period, runs from October 15 through December 7, 2026. That date range is the same one Medicare uses every year, and it is set in law rather than chosen plan by plan. Any change you make during it starts on January 1.

Two things follow from that. First, there is no advantage to acting on October 15 rather than on December 7. A choice submitted on the last day takes effect on the same day as one submitted on the first day, so the reward goes to the person who reviews carefully, not the person who moves fast. Second, the real starting line is now, not October 15. The documents you need are already in your mailbox or your online plan account, and you can read them before the window opens.

Open enrollment is also a once-a-year window with a hard edge. After December 7 your options narrow considerably, which we cover near the end of this post. If you suspect you may want to change something, put December 7 on the calendar today and treat anything earlier as a bonus.

What This Window Lets You Do

Open enrollment is about Medicare Advantage and prescription drug plans. It is not a general reset button for every kind of Medicare coverage, and that distinction trips people up. Here is how it applies depending on what you have now.

If you have today	You can use the window to	Worth knowing
A Medicare Advantage plan	Switch to another Advantage plan, or return to Original Medicare	Returning means adding a drug plan and deciding about Medigap
Original Medicare plus a drug plan	Switch, add or drop the drug plan, or move to Medicare Advantage	Check that the new plan covers your drugs and pharmacy
Original Medicare plus Medigap	Change your drug plan, or move to Medicare Advantage	Giving up Medigap can be hard to reverse

The key point in the last row is that Medigap, also called Medicare Supplement insurance, is not part of open enrollment. This window doesn’t change your Medigap policy, and it doesn’t create a new right to buy one. If you are thinking about leaving a Medigap policy for an Advantage plan, read about how Medigap enrollment rights work first, because in most states an insurer can ask health questions if you try to buy a policy again later.

Our longer guide to the enrollment period covers each option in more depth. This post is the short version, meant to be used rather than studied.

Minutes 1 and 2: Find the Annual Notice of Change

If you are in a Medicare Advantage or Part D plan, your plan is required to send you an Annual Notice of Change before open enrollment begins. In practice it arrives in September, sometimes as a thick envelope, sometimes as an email with a link to your online account. It is usually paired with a longer document called the Evidence of Coverage.

The Annual Notice of Change is the single most useful piece of paper you will handle this fall, and it is routinely ignored. It lists what is different about your plan next year compared with this year. Look for four things on it:

• Your monthly premium and your deductible, if the plan has one.
• Changes to copays and coinsurance for the services you actually use, such as primary care visits, specialists, imaging and hospital stays.
• The yearly maximum you could pay out of pocket for covered services under an Advantage plan.
• Any change to your drug coverage, including drugs that moved to a different tier, drugs that now need approval first, and drugs that are no longer covered.

If you can’t find the notice, call the number on the back of your member card or log in to your plan’s website and look under documents or mail. Don’t wait for it to turn up. Without it you are guessing about 2027.

Minutes 3 and 4: Write Down Every Prescription, Dose and Pharmacy

Take a plain sheet of paper and list each medication you take regularly. Write the name, the dose and how often you take it. Add any drug you use only seasonally or occasionally but would hate to pay full price for. Then write down the pharmacy, or pharmacies, that you actually use, including any mail-order service.

This list does the heavy lifting later. A drug plan is a formulary, which is the plan’s list of covered drugs, and each drug sits on a tier that determines what you pay. Plans can also attach rules to a drug:

• Prior authorization means the plan must approve the drug before it pays.
• Step therapy means you may be required to try a cheaper drug first.
• Quantity limits cap how much you can get in a given period.

Pharmacies matter too. Many plans have preferred pharmacies where your cost is lower, and a pharmacy you like may be in the network but not the preferred network. A plan that looks cheaper on paper can cost more in practice if your drugs land on higher tiers or your pharmacy isn’t preferred.

Part D plans, whether stand-alone or built into an Advantage plan, can change their formularies each year. If you want the background on how those lists work, our overview of Medicare Part D walks through tiers and costs in plain terms. For the yearly out-of-pocket limit that applies in 2027, see our explainer on the Part D cap and what counts toward it.

Minutes 5 and 6: List Your Doctors, Specialists and Hospital

Do the same exercise for your care team. Write down your primary care doctor, each specialist you see, the hospital you would go to and any other provider you rely on, such as a physical therapist or a dialysis center. Next to each name, note whether you are comfortable going elsewhere if you had to. For some people the answer is easy. For others, the relationship with one cardiologist or one oncology team is the whole point.

If you are in an Advantage plan, your plan has a network, and who is in it can change from year to year. Provider directories are a starting place but they are not perfect, so for any doctor you cannot do without, call the office and ask whether they will be in network for the plan next year. Ask by the exact plan name, because a doctor can participate in one plan from an insurer and not another.

If you have Original Medicare, networks are much less of an issue, because you can see any provider who accepts Medicare. That flexibility is a real feature, and it is also the reason some people stay in Original Medicare even though it can cost more in premiums.

Minute 7: Look for a Letter Saying Your Plan Is Leaving

Not every letter is a change notice. Sometimes a plan tells members it won’t be offered at all next year. That is called a non-renewal, and it works very differently from an ordinary change. If your plan is leaving, you generally get an additional enrollment window after open enrollment ends, and in some cases you gain rights to buy a Medigap policy without answering health questions.

A non-renewal notice is typically mailed in early October, so if your mailbox has been quiet, check it again this week. The letter will usually say in plain terms that the plan is ending or will no longer serve your county. Keep it. It may become proof later. We cover the details, including what happens if you do nothing, in our post on what to do if your Medicare Advantage plan is shrinking or leaving your area.

Plan exits and cutbacks are common enough that this check is worth making every year. KFF’s analysis of 2027 plan data found that the average Medicare beneficiary will have 28 Medicare Advantage drug plan options next year, down from 32 this year, and that Ohio saw one of the larger declines in the country, eight fewer options on average, while still remaining among the states with the most choices. CMS, for its part, says roughly eight in ten Advantage enrollees will be able to stay in their current plan with the same or a lower premium. Both statements can be true at once, and the way to know which group you’re in is to read your own notice.

Minutes 8 and 9: Compare Total Cost, Not Just the Premium

Now you have the facts about your current plan. If everything still works, you may be finished. If something changed, or if you simply want to see what else is out there, compare plans on total cost for the way you really use care.

A sensible comparison looks at:

• The monthly premium, which is the number everyone notices first.
• The deductible and the out-of-pocket maximum, which tell you your worst-case exposure on covered services.
• The copays for the services you use often, not the average person’s services.
• What your specific drugs would cost on that plan’s formulary, tier by tier.
• Whether your doctors, hospital and pharmacy are in the network.
• Extra benefits you would actually use, such as dental or vision allowances, as opposed to ones that just look good in a brochure.

Medicare’s own Plan Finder at Medicare.gov lets you enter your drugs and pharmacies and compare plans in your area. It is free, and it is a good neutral check on anything a salesperson, including us, tells you. For free one-on-one counseling that isn’t tied to selling a plan, every state has a State Health Insurance Assistance Program. In Ohio it is the Ohio Senior Health Insurance Information Program, and you can reach it at 800-686-1578. You can also call 1-800-MEDICARE.

Minute 10: Decide What Would Make You Switch

Before you go any further, write down the conditions under which you would change plans. This sounds odd, but it protects you from the most common failure of open enrollment, which is being talked out of a plan that works. A reasonable rule might look like this: stay if my doctors and drugs are still covered and my total expected cost is similar; look harder if either one changes; switch only if another plan is clearly better on the things I actually use.

If you do nothing during open enrollment, you generally stay in your current plan for the new year, with whatever changes it announced. That is fine when the changes are small and you’ve checked. It is not fine when the notice contained something you never read.

If You Wait Until After December 7

Open enrollment closes on December 7, and the window after it is narrower. People who are in a Medicare Advantage plan get a Medicare Advantage Open Enrollment Period from January 1 through March 31, which allows one change: to another Advantage plan, or back to Original Medicare, where you can also join a drug plan. That second chance exists only for people already in an Advantage plan. If you have Original Medicare, with or without a stand-alone drug plan, there is no equivalent winter window.

Outside those windows, you generally need a special enrollment period, which requires a qualifying event such as moving, losing other coverage, or having your plan leave Medicare. In other words, procrastination has a real cost. If any part of your review makes you think a change could be right, finish it before December 7.

Pressure, Scams and Cold Calls During the Window

The weeks around open enrollment are peak season for aggressive marketing and outright fraud. A few habits help. Be cautious with unsolicited calls, texts and mailers. Don’t share your Medicare number with anyone who contacted you first. Be wary of anyone who says you must act today, who claims a benefit is only available through them or who offers a gift for switching. A real plan comparison doesn’t have a deadline of tonight. Our post on Medicare fraud and scam warning signs lists specific patterns to watch for.

Frequently Asked Questions

Do I have to do anything if I’m happy with my plan?

You don’t have to enroll in anything, and your plan generally continues. You should still read the Annual Notice of Change, because the plan can change premiums, benefits, networks and drug coverage even when the plan stays the same.

Can I change plans after December 7?

Sometimes. People in an Advantage plan get one change between January 1 and March 31. Others need a special enrollment period tied to a qualifying event, such as a move or a plan leaving Medicare.

Does open enrollment change my Medigap policy?

No. Medigap isn’t part of open enrollment, so this window neither changes your policy nor guarantees you can buy one. Your drug plan, however, is part of it.

When do the changes I make take effect?

Changes made during open enrollment take effect on January 1, 2027, no matter when in the window you make them.

Is there a cost to get help comparing plans?

You can get free counseling from your State Health Insurance Assistance Program. Licensed independent agents are also paid by insurers rather than by you, which means you pay the same premium whether or not you use one.

Have questions about your own notice or your options for 2027? Talk with our independent team, by phone or video wherever you live, with no cost and no obligation.