Medicare Open Enrollment Starts October 15: 5 Changes to Look for in Your Plan's Annual Notice

If you have a Medicare Advantage plan or a Part D prescription drug plan, a fairly thick envelope should already be sitting somewhere in your house. It is called the Annual Notice of Change, and plans are required to send it by September 30. It is easy to toss it on the pile with all the glossy Medicare ads that arrive this time of year. That would be a mistake, because this one document tells you what your plan will cost and cover starting January 1.

Medicare open enrollment runs from October 15 through December 7. During that window, you can switch plans for the coming year. The notice is your best tool for deciding whether to stay put or shop around, and the time to read it is now, before the window opens. Here are five changes to look for, in the order that tends to matter most to household budgets.

Change 1: The monthly premium

Start with the simplest number. Look for the plan's monthly premium for the new year and compare it with what you pay now. Some Medicare Advantage plans have no premium beyond the Part B premium you already pay, but that can change. Part D plan premiums can rise or fall from year to year.

Write down the new amount and multiply it by 12. A $15 monthly increase may not sound like much, but it adds up to $180 over the year. If your premium is deducted from your Social Security payment, a change here will also show up in your net deposit next year.

Change 2: Deductibles, copays, and the out-of-pocket limit

Next, look at what you pay when you actually use care. The notice lists changes to deductibles, copays for doctor and specialist visits, hospital stays, and other services. For Medicare Advantage plans, also look for the yearly maximum out-of-pocket amount, which caps what you pay for covered medical services in a year.

Think about how you used care this year. If you see specialists often, a $10 increase per specialist visit could matter more than a small premium change. If you rarely go to the doctor, the premium may weigh more heavily. A notebook list of your visits over the past year makes this comparison much easier. Your plan's explanation of benefits statements, mailed or posted online, can help you rebuild that list if you did not keep one.

Change 3: Your prescriptions

For many people, this is the most important section. Plans can change their list of covered drugs, known as the formulary, and move drugs between price tiers. A drug that was on a low-cost tier this year could move to a higher one, or need prior approval, or be dropped altogether.

Make a list of every prescription you take, including the dose, and check each one against the new formulary. Also look at drug deductibles and copays. One helpful change in recent years is the yearly cap on out-of-pocket costs for covered Part D drugs. It was $2,100 in 2026 and rises to $2,400 in 2027, according to Medicare's published figures. Once you hit the cap, you pay nothing more for covered drugs that year.

If your costs tend to come in large chunks early in the year, you may also want to ask your plan about the Medicare Prescription Payment Plan, an option that spreads drug costs into monthly payments across the year.

Change 4: Doctors, hospitals, and pharmacies in the network

Medicare Advantage plans usually have networks of doctors and hospitals. Part D plans often have preferred pharmacies with lower prices. Networks can change from one year to the next, sometimes in ways that are not obvious from the notice.

Check whether your primary care doctor, specialists, and preferred hospital will still be in the network next year. The notice may point you to the plan's provider directory. Because directories are not always up to date, it is a good idea to call your doctors' offices and ask directly whether they plan to stay in network for the coming year. Do the same for your usual pharmacy, and ask whether it will remain a preferred pharmacy with lower copays.

Change 5: Extra benefits like dental, vision, and hearing

Many Medicare Advantage plans include extras that Original Medicare does not cover, such as dental cleanings, eyeglasses, hearing aids, fitness memberships, or an allowance for over-the-counter items. These benefits can be generous one year and trimmed the next.

If you rely on any of these, read the details. A dental benefit might keep the same name but cover fewer services or come with a lower yearly limit. A grocery or over-the-counter allowance might shrink or disappear. Decide which extras you actually use, and focus on those rather than the longest list of perks.

What to do between October 15 and December 7

Once you know how your plan is changing, you can decide whether to keep it or compare. If the changes are minor and your doctors and drugs are still covered, staying put may be fine. If you generally do nothing and your plan is still offered, you are usually renewed in the same plan for next year.

If you want to compare, the Medicare Plan Finder on Medicare.gov lets you enter your drugs and pharmacies to see estimated costs for plans in your area. You can also call 1-800-MEDICARE. For free, unbiased one-on-one help, contact your State Health Insurance Assistance Program, often called SHIP, which has trained counselors who do not sell insurance. Any plan change you make during open enrollment generally takes effect January 1.

Two special situations are worth knowing about. If your plan is leaving Medicare or your area next year, you should receive a separate non-renewal notice explaining your options, and you will generally have a special window to choose new coverage. Read that letter carefully, because waiting too long can leave you with fewer choices. And if you are in a Medicare Advantage plan and regret your choice after January 1, there is a separate Medicare Advantage open enrollment period from January 1 through March 31, when you can make one switch to another Medicare Advantage plan or to Original Medicare.

Whatever you decide, keep your notice and any plan comparison printouts in one folder. They are handy if a bill or pharmacy charge in January does not match what you expected.

Be wary of high-pressure sales pitches

Open enrollment season brings a flood of mailers, TV ads, and phone calls. Some are legitimate, and some are not. Medicare will not call you to sell a plan or ask for your Medicare number out of the blue. Do not give your Medicare number, Social Security number, or bank information to anyone who contacts you unexpectedly. If an offer sounds too good to be true, check it with SHIP or 1-800-MEDICARE before you sign anything.

Get your notice out this week

Find that Annual Notice of Change, sit down with your list of prescriptions and doctors, and go through the five changes above. Mark anything that will cost you more or limit your care. With that short list in hand, you will be ready to make a calm decision once open enrollment begins on October 15, instead of rushing in early December.