7 Tips for Medicare Open Enrollment

1. Know the dates.

Medicare Open Enrollment happens each year from Oct. 15 to Dec. 7. This is when current Medicare beneficiaries can review their benefits and make changes to their plans. Any changes you make during this period take effect on Jan. 1 of the following year. Mark those dates on your calendar well in advance. The window is only about seven weeks, and it goes faster than you’d expect.

If you miss this window, you generally can’t make changes to your coverage until the following year, unless you qualify for a Special Enrollment Period due to a specific life event.

It’s also important to note that Medicare Open Enrollment is for current beneficiaries only. People enrolling in Medicare for the first time are eligible to sign up during the three months before and three months after their 65th birthday. Failing to enroll during this initial window may result in permanent late enrollment penalties.

2. Be willing to consider your options.

Even if you’re happy with your current plan, it may have changed. Your insurance company is required to send you an Annual Notice of Change, or ANOC, before open enrollment begins. This document outlines what is changing for the coming year. That could include premiums, covered services, drug formularies, and network providers. Read it carefully. What worked well this year may not be the best fit for your situation next year.

3. Review your prescription drug coverage.

Medications are often the biggest variable in choosing the right plan, and the details change annually. Use Medicare’s Plan Finder tool at www.medicare.gov to compare how your specific prescriptions are covered under different plans. Before you sit down to use it, pull together a current list of all your medications, including dosages. The tool can calculate estimated annual drug costs based on your specific prescriptions, which makes plan comparison far more accurate than comparing premiums alone.

4. Verify your preferred doctors are still in-network.

Provider networks matter. Even if you think you’re keeping the same plan, check to make sure your doctors and their clinics are still in-network. If they aren’t, you may not be able to schedule appointments after Jan. 1, even for providers you’ve seen for years. This is an easy thing to overlook and a painful one to discover after the fact.

5. Understand that help is available.

Medicare is genuinely complicated, and there’s no shame in asking for guidance. Here are some of the best places to turn, including some free community resources:

• SHIP (State Health Insurance Assistance Program) — every state has one, offering free and unbiased counseling from trained volunteers. Find your local contact at shiphelp.org.
• 1-800-MEDICARE—the official Medicare helpline is staffed 24 hours a day, 7 days a week, and can walk you through plan options at no cost.
• Your local Area Agency on Aging—many offices host open enrollment educational events during the fall window.
• Independent insurance brokers—can compare plans across multiple carriers. Just keep in mind that because they earn a commission, it’s worth cross-checking their recommendations with an unbiased source like SHIP.

6. Check whether you qualify for extra help.

Some Medicare beneficiaries qualify for programs that can help cover premiums and out-of-pocket costs but may not know to look for them. If cost is a concern, visit www.benefits.gov or contact your state Medicare office to find out whether you may be eligible for a Medicare Savings Program. It’s worth a few minutes to check.

7. Make the most of your window.

Open enrollment is your opportunity to take charge of your Medicare coverage. A little preparation goes a long way. Read your Annual Notice of Change, gather your medication list, compare your plan options, confirm your providers are still in-network, and make your decision before Dec. 7. Your future self will thank you.

Note: This post is intended for general informational purposes. Medicare rules and plan details change annually. Consult a licensed insurance counselor or visit medicare.gov for the most current information specific to your situation.