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What Changes Can I Make During Medicare Open Enrollment?

Medicare Open Enrollment—officially known as the Annual Election Period (AEP)—is the primary window each year for beneficiaries to re-evaluate their healthcare coverage. Because Medicare plans can change their premiums, provider networks, and drug formularies annually, this period is your best opportunity to ensure your coverage still aligns with your health needs and budget.

 

For the 2026 coverage year, the Open Enrollment period runs from October 15 to December 7, 2025. Any changes you make during this window will take effect on January 1, 2026.

 

1. Switching Between Original Medicare and Medicare Advantage

One of the most significant moves you can make is changing how you receive your Medicare benefits.

  • From Original Medicare to Medicare Advantage: You can move from the government-run program (Parts A and B) to a private Medicare Advantage (Part C) plan. These plans often bundle dental, vision, and hearing coverage, which Original Medicare does not typically include.

     

  • From Medicare Advantage back to Original Medicare: If you find that your current private plan’s network is too restrictive or costs have risen, you can return to Original Medicare.

     

Important Note on Medigap: If you return to Original Medicare, you may want to apply for a Medicare Supplement (Medigap) policy. However, unless you have “guaranteed issue” rights, private insurers in most states can use medical underwriting to deny you coverage or charge higher premiums based on your health history.

 

2. Modifying Your Medicare Advantage Plan

If you are already enrolled in a Medicare Advantage plan, you aren’t stuck with it. During Open Enrollment, you can:

 

  • Switch to a different Medicare Advantage plan: You might find a different private insurer that offers a lower premium, a better “Maximum Out-of-Pocket” limit, or includes your preferred specialists in their 2026 network.

  • Change your drug coverage status: You can move from a Medicare Advantage plan that does not include drug coverage to one that does, or vice versa.

     

3. Adjusting Prescription Drug Coverage (Part D)

Prescription drug plans (PDPs) are notorious for changing their “formularies” (the list of covered drugs) and tier pricing every year.

  • Join a Part D plan: If you didn’t sign up for drug coverage when you first became eligible, you can join a plan now (though a late-enrollment penalty may apply).

     

  • Switch Part D plans: This is the most common change. By using the Medicare Plan Finder tool, you can see which 2026 plan offers the lowest total annual cost for your specific medications.

  • Drop Part D coverage: You can remove your drug plan entirely, though this is generally discouraged unless you have other “creditable” coverage (like through a former employer).

     

What You Cannot Do During This Period

While the Fall Open Enrollment is flexible, it doesn’t cover everything. You cannot:

  • Enroll in Medicare for the first time: If you missed your Initial Enrollment Period (around your 65th birthday), you typically must wait for the General Enrollment Period (January 1 – March 31).

     

  • Buy a Medigap policy with guaranteed rights: In most states, Open Enrollment does not grant you a “free pass” to buy a Medigap plan without health questions.

Helpful Resources

Before making a choice, consult these official and non-profit resources to compare plans: