**By 50 Plus Hub Staff**
Medicare's Annual Enrollment Period (AEP) runs from October 15 through December 7 each year, giving beneficiaries a seven-week window to review and change their coverage. Understanding the timeline and recent changes can help you make informed decisions about your healthcare coverage for the coming year.
## Critical Enrollment Dates
The Medicare enrollment calendar includes several important periods throughout the year:
**Annual Enrollment Period (AEP)** - Runs October 15 - December 7 - Changes take effect January 1 - Available to all Medicare beneficiaries - Can switch between Original Medicare and Medicare Advantage - Can change Part D prescription drug plans - Can add or drop Part D coverage
**Medicare Advantage Open Enrollment Period** - Runs January 1 - March 31 - Only for those already enrolled in Medicare Advantage - Can switch to a different Medicare Advantage plan - Can return to Original Medicare and join a Part D plan - Limited to one change during this period
**Initial Enrollment Period** - Three months before turning 65 - Your birth month - Three months after turning 65 - Total of seven months
**Special Enrollment Periods** - Triggered by qualifying life events - Moving outside your plan's service area - Losing other coverage - Moving into a nursing home - Qualifying for Extra Help with prescription costs
## What Changed in 2026
Several significant changes took effect this year that impact Medicare beneficiaries:
**Part D Prescription Drug Improvements**
The Inflation Reduction Act continued its rollout of prescription drug reforms:
- Out-of-pocket cap reduced to $2,000 annually (down from $3,300 in 2025) - No cost-sharing for recommended vaccines, including shingles - Monthly payment option for Part D costs spread throughout the year - Insulin costs capped at $35 per month for all covered insulin products - Medicare now negotiates prices for additional high-cost drugs
**Premium and Cost Changes**
Part B premiums and deductibles adjusted for 2026:
- Standard Part B premium: $185 per month (up from $174.70 in 2025) - Part B deductible: $257 (up from $240 in 2025) - Part A deductible: $1,676 per benefit period (up from $1,632 in 2025)
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**Medicare Advantage Plan Changes**
Insurers made significant adjustments to Medicare Advantage offerings:
- Many plans reduced supplemental benefits or increased cost-sharing - Some insurers exited certain markets or reduced service areas - Prior authorization requirements expanded for some services - Network changes affecting which doctors and hospitals are covered
**Telehealth Extensions**
Congress extended several telehealth flexibilities originally introduced during the pandemic:
- Audio-only visits still covered for mental health services - Rural beneficiaries retain expanded telehealth access - Coverage continues for telehealth from home (not just at medical facilities)
## How to Review Your Coverage
Take these steps during the enrollment period to ensure your coverage meets your needs:
**Review Your Current Coverage** - Check if your doctors remain in network - Verify your prescriptions are still covered at the same cost tier - Review any changes to co-pays, deductibles, or out-of-pocket maximums - Assess whether supplemental benefits match your needs
**Compare Available Plans**
Use the official Medicare Plan Finder at Medicare.gov to:
- Enter your prescriptions to compare drug costs across plans - Check if your preferred doctors accept different plans - Compare total estimated annual costs, not just monthly premiums - Review quality star ratings for Medicare Advantage and Part D plans
**Consider Your Health Needs**
Think about anticipated changes:
- Upcoming procedures or treatments - New medications your doctor mentioned - Desire for dental, vision, or hearing coverage - Travel plans that might affect coverage area - Preference for specific doctors or hospitals
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## Common Mistakes to Avoid
**Missing the Deadline**
If you miss the December 7 deadline without a qualifying special enrollment reason, you typically must wait until the next Annual Enrollment Period. Exception: The Medicare Advantage Open Enrollment Period (January 1 - March 31) offers limited options for those already in Medicare Advantage plans.
**Focusing Only on Premium**
A plan with a low monthly premium might have high deductibles, co-pays, or out-of-pocket maximums. Calculate total expected annual costs including:
- Monthly premiums - Prescription drug costs - Expected doctor visits and specialist co-pays - Deductibles and maximum out-of-pocket costs
**Ignoring Network Changes**
Medicare Advantage plans regularly update their provider networks. Your current doctor might not be in network next year even if you keep the same plan. Always verify network status during enrollment.
**Not Reviewing Annually**
Plans change their costs and coverage every year. What worked last year might not be the best option now. Set aside time each October to review your situation.
## Resources for Enrollment Help
**Official Medicare Resources**
- Medicare.gov: Plan Finder tool and official information - 1-800-MEDICARE (1-800-633-4227): 24/7 assistance, TTY 1-877-486-2048 - Medicare.gov/talk-to-someone: Find local help
**State Health Insurance Assistance Programs (SHIP)**
Free, unbiased counseling available in every state:
- One-on-one assistance reviewing plan options - Help understanding Medicare notices and bills - Information about programs for people with limited income - Find your state program at ShipHelp.org
**Extra Help Programs**
If you have limited income and resources, you may qualify for assistance:
- Extra Help with Part D costs (income limits: $23,275 individual, $31,350 couple) - Medicare Savings Programs that pay Medicare premiums - State pharmaceutical assistance programs - Apply at SSA.gov/medicare/prescriptionhelp or call Social Security at 1-800-772-1213
## Bottom Line
Medicare's Annual Enrollment Period from October 15 through December 7 offers your primary opportunity to change coverage for the following year. With the $2,000 prescription drug out-of-pocket cap now in effect and continued premium increases, reviewing your coverage has never been more important.
Take advantage of the Medicare Plan Finder tool, consider your anticipated healthcare needs for the coming year, and don't hesitate to use free SHIP counseling services. The time invested in reviewing your options during enrollment can save hundreds or thousands of dollars while ensuring you have appropriate coverage for your health situation.