What to Do During Medicare Open Enrollment

When and how to make changes to your Medicare coverage

Medicare Open Enrollment runs from October 15 through December 7 each year. During this window, you can switch between Original Medicare and Medicare Advantage plans, change your prescription drug coverage, or drop coverage altogether. Outside this period, you cannot make most changes unless you have a may have access to life event — like turning 65, losing employer coverage, or moving to a new state.

You do not need to do anything if you are happy with your current plan. Medicare will automatically renew your coverage on January 1. But if your plan's costs are rising, your doctors are leaving the network, or your medications are no longer covered the same way, Open Enrollment is when you can switch without penalty.

Key Takeaways

• Open Enrollment happens every October 15 through December 7, and changes take effect January 1 of the following year.
• You can compare plans, switch plans, or drop coverage only during this window — outside it, you need a may have access to life event to make changes.
• Gather your current plan documents, a list of your medications, and your preferred doctors' names before you start comparing.
• Medicare.gov's plan comparison tool shows you side-by-side costs, networks, and drug coverage for every plan available in your area.
• You can enroll through Medicare.gov, by phone at 1-800-MEDICARE, or in person at a local Social Security office.

Gather your documents and information before comparing plans

Before you look at new plans, collect three things: your current plan's Summary of Benefits and Coverage (this document shows what you pay now), a complete list of your medications with dosages, and the names of the doctors and specialists you see regularly.

Your Summary of Benefits and Coverage usually arrives in the mail in September, or you can find it on your plan's website or by calling the plan's customer service number. Write down what you currently pay for premiums, deductibles, copays, and coinsurance. This is your baseline for comparison.

For medications, pull out all your prescription bottles or check your pharmacy records. Include over-the-counter drugs you take regularly — some plans cover these differently. For doctors, list your primary care doctor, any specialists you see (cardiologist, rheumatologist, etc.), and any hospitals or urgent care centers you use.

Use Medicare.gov to compare plans side by side

Go to Medicare.gov and select "Find Care Providers and Suppliers" or use the plan comparison tool directly. Enter your zip code, and the tool will show every Original Medicare option, Medicare Advantage plan, and prescription drug plan available in your area. You can filter by monthly premium, deductible, or whether specific doctors are in the network.

For each plan you are considering, check three things: whether your doctors are in-network (out-of-network care costs more), what your total out-of-pocket costs would be for the medications you take, and what the deductible and copays are for services you use most. The tool estimates your annual costs based on your medications and usage patterns.

If you use the same pharmacy regularly, search that pharmacy's name in the plan comparison tool to see which plans include it. Some plans have preferred pharmacies that cost less, and switching pharmacies mid-year can be inconvenient.

Understand the difference between Original Medicare and Medicare Advantage

Original Medicare is run by the federal government and covers hospital care (Part A) and doctor visits (Part B). You can see any doctor who accepts Medicare anywhere in the country. You pay a monthly premium for Part B, a deductible, and copays or coinsurance for each service. You need a separate prescription drug plan (Part D) to cover medications.

Medicare Advantage (Part C) is run by private insurance companies under contract with Medicare. These plans bundle hospital, doctor, and usually prescription drug coverage into one plan. They typically have lower or no monthly premiums than Original Medicare, but you must use doctors in their network (except emergencies). Many include dental, vision, or hearing coverage that Original Medicare does not.

Original Medicare gives you more freedom to choose doctors but may cost more out-of-pocket. Medicare Advantage costs less upfront but limits where you can go. Neither is universally better — it depends on your doctors, your medications, and how much medical care you use.

Make your changes before December 7

You can enroll in a new plan three ways: online at Medicare.gov, by phone at 1-800-MEDICARE (1-800-633-4227), or in person at your local Social Security office. If you enroll online, you will see your confirmation immediately. By phone or in person, you will receive written confirmation in the mail within two weeks.

Your new coverage starts January 1, regardless of when in October or November you enroll. If you wait until early December, you will still have coverage on January 1, but you will have less time to review your choice or fix any mistakes. Enroll by early December to give yourself a buffer.

If you are switching from one Medicare Advantage plan to another, or from Medicare Advantage to Original Medicare, your old plan ends on December 31. You do not need to cancel it separately — the new plan takes over automatically. If you are dropping Medicare Advantage to go back to Original Medicare, make sure you also enroll in a Part D prescription drug plan at the same time, or you may face a late-enrollment penalty.

What happens after you enroll

Your new plan's insurance card will arrive in the mail by December 20. Do not throw away your old card until you receive the new one. Starting January 1, use only your new card at the doctor's office, hospital, or pharmacy.

If you switched plans and your current medications are not covered the same way, contact your new plan's pharmacy department before January 1 to ask about coverage. Some plans require prior authorization (the plan's permission) before the pharmacy will fill certain drugs. If your new plan does not cover a medication the way your old plan did, ask your doctor whether there is a covered alternative, or ask the plan about an exception.

If you made a mistake during enrollment — chose the wrong plan, entered your information incorrectly, or changed your mind — you have until December 31 to make another change. After that, you are locked into your plan until the next Open Enrollment in October, unless you have a may have access to life event.

If you missed the deadline or have a may have access to life event

If Open Enrollment has passed and you did not make changes, you are generally locked into your current plan for the rest of the year. However, certain life events allow you to enroll or switch plans outside the regular window. These include turning 65, losing employer coverage, moving to a new state, getting married or divorced, or experiencing a significant drop in income.

If you have a may have access to event, you usually have 60 days from the date of the event to make changes. Contact Medicare at 1-800-MEDICARE to report the event and enroll in a new plan. You will need to provide proof — a birth certificate for turning 65, a letter from your employer for losing coverage, or a lease for moving.

Some people also may have access to for Special Enrollment Periods if they are Indian Health Service users, live in certain territories, or meet other specific criteria. Call 1-800-MEDICARE to find out whether you may have access to.

Frequently Asked Questions

Can I switch plans more than once during Open Enrollment?

Yes. You can change your mind as many times as you want between October 15 and December 7. Each new enrollment cancels the previous one. Your final enrollment — the one active on January 1 — is the one that counts. Make sure you know which plan you chose by checking your confirmation letter.

What if my doctor is not in my new plan's network?

If you discover this after January 1, contact your new plan immediately and ask about out-of-network coverage or whether your doctor can be added to the network. Some plans cover out-of-network care at a higher cost. If your doctor is not available any way, you may be able to switch plans again if you report this as a network issue within a certain timeframe — ask your plan about their process.

Do I have to choose a new plan every year?

No. If you are satisfied with your current plan and its costs are not changing significantly, you can keep it. Medicare will automatically renew your coverage on January 1. You only need to act if you want to make a change.

What is the penalty for not having Part D prescription drug coverage?

If you go without Part D coverage for more than 63 days in a row, you will pay a permanent penalty on top of your Part D premium for as long as you have Medicare. The penalty amount changes each year. If you did not have coverage when you were first may be able to access, enroll as soon as possible to limit the penalty.

Can I get help choosing a plan?

Yes. State Health Insurance Assistance Programs (SHIP) offer free, one-on-one counseling to help you compare plans. Call 1-800-MEDICARE and ask for your state's SHIP program, or search "SHIP" plus your state name online. Counselors can review your medications, doctors, and costs to help you decide.