Annual open enrollment for Medicare runs from Oct. 15 through Dec. 7. This is the time that Medicare beneficiaries can amend their health and prescription plan coverage for 2026. Plan changes take effect on Jan. 1, 2026.

According to Fidelity, a 65-year-old retiring in 2025 could spend $172,500 on health care and medical expenses in retirement. This amount increased from $165,000 in 2024.

Take the time to compare

It is not easy to change your health insurance plan, so the path of least resistance may be to just stick with what you have, and your plan automatically renews. However, keep in mind that insurance plans change every year, and what you need may have changed. For example, your specialty drug may no longer be covered, your preferred doctor may no longer accept your plan or the costs may have increased. Make the time to compare to make sure you have the plan you need, and you may save money next year.

Beware of fraudsters

If you are looking around for plan options during open enrollment, there is an increased risk for fraudulent activity. Medicare has rules for plans as to how they can market their insurance options to you. Plans may send you emails; however, plans are not permitted to call or visit you in person without your permission. If you believe you have experienced a potential marketing violation, contact your local SMP (Senior Medicare Patrol).

2026 changes from 2025

Medicare Open Enrollment for 2026 will bring higher Part B and Part D costs, a Part D out-of-pocket of $2,100 (up from $2,000 in 2025), and a permanent cap of $35 per month for insulin costs. Beginning in 2026, if you participate in the Medicare Prescription Payment Plan (MPPP), you will be automatically re-enrolled the next year unless you opt out. There will be a separate renewal notice after the annual election period ends; the notice will contain the payment plan’s upcoming terms.

Six states (New Jersey, Ohio, Oklahoma, Texas, Arizona and Washington) will have a pre-authorization process when beneficiaries are seeking services under Traditional Medicare. The Wasteful and Inappropriate Service Reduction (WISeR) Model involves CMS partnering with companies with enhanced technology specialization to improve and expedite a prior authorization process. The WISeR model does not impact people enrolled in Medicare Advantage.

Ways to find your options

Explore your Medicare coverage options by going to Medicare 2026 plan options. You may create an account and log in or just use your zip code, county and type of plans to start your research. If you are not comfortable using the computer, contact 1-800-MEDICARE (1-800-633-4227) or your State Health Insurance Assistance Program, for help in plan comparison. Print out the Supplemental Handout at the end of Medicare’s Open Enrollment Period and use it as a guide. Medicare also has a Fact sheet that details the times during and circumstances under which you can sign up for, or change, your plan. The U.S. Department of Health and Human Services has a Medicare & You 2026 booklet with extensive information and an index of topics.

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Tammy A. Weber is a Certified Elder Law Attorney and the Managing Attorney of the law firm of Marshall, Parker & Weber, LLC, with offices in Williamsport, Jersey Shore and Plains. For more information visit www.paelderlaw.com or call 1-800-401-4552.