Every fall, Medicare has an Open Enrollment period from October 15 through December 7.

Many older adults tune this out, figuring their coverage is probably ok. But this is a big mistake, and is part of the reason that millions of them overspend on their Medicare coverage.

Reviewing your Medicare plan every year is important! Every older adult either has a Medicare D drug plan, or is on a Medicare Advantage plan. Both these types of plans often change their fees and/or coverage for the following year. So, it often makes sense to switch to a different plan for next year.

Now, it used to be a huge hassle to try to compare plans and figure out which one might be better for next year. But today it can be relatively easy, thanks to some newer services and tools.

To help you through the process, in this article I’ll share the six steps I recommend you take during Medicare Open Enrollment.

You can also watch me explain these steps in this video:

 

An Easy Option: Get Free Help From a Medicare Advisor

Before I take you through the steps, I want you to know about a super easy and free option:

Last year, my geriatric social work colleague Michelle and I tried Chapter out for the first time. Michelle routinely walks older adults through reviewing their Medicare coverage, so she was able to compare it to what she usually does. We both found it very helpful.
Here’s why I recommend them:

• They can look at every plan nationwide. They’re the only Medicare advisors I know of who can do this, to help find the best plan for your specific situation.
• The individual advisors are unbiased. Chapter pays its advisors a salary, so they’ll tell you if your current plan is your best option. If it’s not, they’ll help you switch.
• It’s free to you. (I explain how Chapter makes money further below.)

Chapter does offer a small referral commission to partners, so if you call them and end up changing your Medicare plan through their service, Better Health While Aging will receive a little money and you will be helping to support my work! But I wouldn’t recommend them unless I thought it was a good service. Several people in my audience used Chapter last year and gave it good reviews.

That said, the 6 steps below are worth doing whether or not you call Chapter. So let’s talk about why Open Enrollment matters.

Why Do Anything During Medicare Open Enrollment?

Most older adults are either in a Medicare Advantage plan (sort of like an HMO version of Medicare) or in Traditional Medicare with a stand-alone Part D plan to cover prescription drugs.

For both Medicare Advantage and Part D, plans are allowed to change what they do every year. So often they will:

• Increase their premiums
• Change their deductibles and copays
• Drop or change benefits
• Change which doctors and hospitals are in their networks
• Change which drugs are on their formularies (their list of covered drugs)

Things can and do really change from one year to the next!

When older adults review their options during Open Enrollment, they often find that they can:

• Save money while getting the same kind of care
• Keep or get access to the doctors and hospitals they want
• Make sure they’ve found the most affordable way to get the Medicare coverage that’s right for their needs

What Happens If You Do Nothing?

If you don’t make any changes, your Medicare plan will automatically renew, unless it has been canceled. (And a fair number of plans are being canceled this year; more on that below.)

But here’s the key thing to understand: automatic renewal does NOT mean everything stays the same.

Your plan may renew with higher costs, different coverage, or reduced benefits. So if you do nothing, you can easily end up paying more than you did last year, and more than you need to, for the medications and providers you want.

That’s why I encourage everyone to engage in this process.

Now let’s go through the steps.

6 Steps to Take Every Fall for Medicare Open Enrollment

Step 1: Review Your Current Coverage and Your Annual Notice of Change

The first step is to review your current coverage, and find out what is going to change with your plan for 2027.

Here’s what to do:

• Find your Annual Notice of Change (ANOC). Plans must mail you this by September 30, so it should have arrived already.
• Review your current coverage. You can log in to your account at Medicare.gov, and gather your Medicare card and other insurance cards.
• Look for changes to your premium, deductibles, and copays for next year.

If your plan is being canceled

If you received a non-renewal notice, this can actually be a good thing in some ways. Here’s what to know:

• If you do nothing, you will automatically return to Original Medicare starting January 1, unless you choose a new Medicare Advantage plan.
• You get a Special Enrollment Period from December 8 to February 28 to choose a new Medicare Advantage plan or a stand-alone Part D plan.
• You can also use this time to shop for a Medigap (supplemental) policy if you’re going to Original Medicare. This can be a great opportunity because normally Medigap involves medical underwriting, but if your Medicare Advantage plan was canceled, you’re often eligible to get Medigap without medical underwriting.

Step 2: Review Your List of Health Care Providers

Next, make a list of the health care providers you want to keep seeing. Be sure to include:

• Your primary care provider
• Your specialists
• Your preferred hospitals

When it comes to hospitals, I especially recommend ones that have acute care for elders units, delirium prevention programs, or other special programs to reduce the stress of hospitalization for older people.

Then make sure these providers will remain in-network for the plan you have, or the plan you’re considering.

This step matters most if you’re on Medicare Advantage, since these plans have provider networks. If you’re on Traditional Medicare, you generally don’t need to worry about this.

Step 3: Review Your Medications (and Consider Deprescribing)

This is the step that geriatricians pay special attention to.

Start by making a list of all the prescription medications you currently take, including the doses. You’ll need this information when comparing Part D plans or other prescription drug coverage.

But before you start shopping for the right plan to cover your medications, I highly recommend you schedule a medication review with your health provider first.

Here’s why: when we review medications thoughtfully, we often discover that some medications are no longer being taken, or are no longer truly necessary. Identifying these and deprescribing them (meaning, tapering or stopping them in a planned way) can:

• Reduce side effects
• Lower the risk of harmful medication events
• Save you money

So as you think about what Medicare coverage you’ll need for next year, this is a great time to work with your provider and deprescribe any medications that aren’t really needed.

The goal is to have a good, up-to-date medication list before you check Part D drug plans for next year.

For help preparing for a medication review and working with your provider on deprescribing, see Deprescribing: How to Be on Less Medication for Healthier Aging. 

Step 4: Review Your Past Year of Health Care

Now take a moment to reflect on how your health care went this past year. Ask yourself:

• What happened over the past year? Which specialists did you see? Were you hospitalized, or did you need rehabilitation?
• Did you run into any coverage issues? Was there care you wanted, or that was recommended to you, that was hard to get because of your insurance?
• How much did you spend on health care? If it’s easy to figure out, it’s worth knowing.
• Were there any out-of-pocket expenses that were surprising or challenging?

Your answers will help you identify what to look for, and what to prioritize, when you research next year’s coverage.

Step 5: Research Your Options for 2027

Once you’ve done the steps above, it’s time to research your options. Here are the resources I recommend.

Best options

1. Call Chapter Medicare Advisory at (771) 224-0630. This is the easiest option, and the one I’m partnering with this year. (More on how it works below.) I wouldn’t recommend it if Michelle and I hadn’t tried it and found it helpful.
2. Use Medicare.gov’s Plan Finder tool. The online Plan Finder lets you enter your prescriptions and pharmacies and compare plans on your own time. You can also call Medicare for help, although wait times can be long.

Other options

3. Your State Health Insurance Assistance Program (SHIP). Every state has a SHIP, which offers free counseling on your health insurance options. You can find yours at shiphelp.org.

4. A local insurance broker who specializes in Medicare. If you know a broker you like and trust, or can find one through word of mouth, that’s another reasonable option. Just make sure they specialize in Medicare.

How Chapter helps with Medicare

Here’s how the process works when you call Chapter:

• You’re connected with a trained Medicare advisor.
• The advisor interviews you about your doctors and specialists, your prescriptions, and your priorities.
• Using a large database of virtually all available plans nationwide, they generate a list of options that fit your needs.
• They can email you the plan information so you can compare a few options and think it over.
• If your current coverage is your best choice, they’ll tell you so. If another option looks better, they can help you switch.

The feedback I’ve gotten from people who tried it last year is that it was easy and convenient.

How can Chapter be free?

When I first heard about Chapter, I wanted to know: How do they make money, if the service is free to older adults? And how do we know they’re recommending the best choices?

The answer is that Chapter makes money the same way all Medicare insurance brokers and agents do: they receive a commission from many (though not all) plans when you sign up through them.

What’s unique is that Chapter’s individual advisors are on salary, and they don’t know which plans generate more or less commission for the company. This means the advisors can stay unbiased and focus on what’s truly the best fit for you.

Step 6: Make Your Medicare Choice(s) for 2027

The final step is to make your decision. Here’s what I suggest:

• Give yourself some time to review your options.
• Talk it over with someone, especially your health care power of attorney and/or an adult child.
• Make any changes by December 7.

Looping in your care circle is a great idea even if no one is helping you with your coverage right now. It’s a natural opportunity to update them on your health and your insurance. That way, if you got sick or hospitalized and they needed to step in, they’d have a foundation to help you.

Note: If you’re on Traditional Medicare or considering switching to it, the 2027 Part B premiums are usually announced in late November. That’s when you’ll know exactly what that option will cost.

Additional Considerations

Switching from Medicare Advantage to Original Medicare? Think about Medigap first.

Many people on Original Medicare like to have a Medigap (Medicare Supplement) plan to help cover the 20% of costs they’d otherwise be responsible for.

However, if you switch from Medicare Advantage to Original Medicare, it can be hard to get an affordable Medigap plan. That’s because when you first join Medicare, you can buy Medigap without medical underwriting. After that, insurers can usually look at your age and health problems and decide whether to cover you, and at what price.

The exception: If your Medicare Advantage plan was canceled, you’re often eligible to get Medigap without medical underwriting. This can be a valuable opportunity, which is why a plan cancellation isn’t always bad news.

If you’re struggling financially, check for assistance programs

There are programs that help Medicare beneficiaries with limited income pay for premiums, copays, and prescription drugs. It’s worth checking whether you’re eligible. I’ve covered some of these in my other Medicare videos, and online searches (including AI-assisted searches) are now pretty good at surfacing these options.

Medicare Advantage members get one more chance to change

If you’re in a Medicare Advantage plan, you can make one change between January 1 and March 31. So if you switch plans and find that the new one isn’t working for you, you’ll have an opportunity to adjust.

What’s New for 2027

Here’s a quick overview of the important changes this year:

• Insurers are cutting back on Medicare Advantage. Medicare Advantage options are decreasing in 28 states. This means you might lose your plan, or see your benefits reduced.
• Part D premiums may rise. A subsidy that had been helping to hold down premiums has expired.
• The Part D out-of-pocket spending cap is increasing to $2,400 (up from $2,100 in 2026).
• 15 more drugs now have negotiated prices, including some popular ones such as Ozempic, Wegovy, and Trelegy.

Recap: 6 Steps for Medicare Open Enrollment

1. Review your current coverage and your Annual Notice of Change.
2. Review your list of health care providers and make sure they’ll be in-network.
3. Prepare your updated medication list for 2027. Review your medications with a health care provider and deprescribe any that are no longer needed, before you shop for drug coverage.
4. Review your past year of health care. Did you have any coverage problems or surprising out-of-pocket expenses?
5. Research your options for 2027. For the easiest option, I recommend calling Chapter at (771) 224-0630.
6. Make your Medicare coverage choice(s) for 2027 by December 7.

I know Medicare Open Enrollment can feel overwhelming. But taking a little time now can help you avoid overpaying, keep the doctors you want, and make sure your medications are covered next year.

Good luck with your Open Enrollment! If you call Chapter, I’d love to hear how it goes. Let me know in the comments here or on my related video on Medicare Open Enrollment.

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