Medicare Open Enrollment 2026: What to Check Before December 7

Medicare open enrollment 2026 started on Thursday, October 15, and it runs through December 7. Anything you pick during that window takes effect on January 1, 2027, and this year more people than usual have a reason to look. Insurers are trimming Medicare Advantage options and county footprints, the Part D out-of-pocket cap climbs to $2,400, the standard Part D deductible rises to $700, and a temporary government subsidy that kept drug plan premiums down is ending after 2026. At the same time, a one-time $90 payment aimed at Part B premiums is going out to some people on Original Medicare, while roughly 35 million Medicare Advantage members are left out of it. If your current plan sent a notice saying it will not be offered next year, the clock is real. Even if it did not, a few minutes of comparison can change what you pay. We’ll be updating this article monthly.

The numbers explain why this season feels different. Government figures show the total count of Medicare Advantage plans slipping only slightly, from 5,553 to a projected 5,532, but that small national change hides large moves underneath. Analysts say Humana is dropping about 2,400 plans and UnitedHealthcare about 690, Centene is leaving 344 counties, and insurers expect enrollment to fall to about 34 million, roughly 2 million fewer than now. Meanwhile, Original Medicare is not standing still either. The Part B premium is projected to rise to $209.50 a month, and the official figure arrives in November. This guide walks through the dates, the new costs, who is affected, how to switch, how long it takes and when money actually moves, and it comes with a calculator that compares your two main paths.

Medicare Open Enrollment 2026 Dates Key Highlights

What Is Medicare Open Enrollment, and Who Can Use It?

The yearly enrollment period lets anyone with Medicare change how they get coverage for the following year. You can move from Original Medicare to a Medicare Advantage plan, move back, switch from one Advantage plan to another, or add, drop and change a Part D prescription drug plan. If you are happy with your plan and it is continuing, you do not have to do anything, and your coverage simply renews. The exception is when your plan is leaving the market or changing in ways that matter to you. Plans must send an annual notice of changes in the fall, and reading that letter is the single cheapest thing you can do this month.

Open enrollment is also separate from the first time you sign up for Medicare. If you are turning 65, you have a seven-month initial window around your birthday month, and that does not depend on the fall calendar. Anyone who delays Part B or Part D without other qualifying coverage may owe a late enrollment penalty for as long as they have the coverage, which is why timing matters even for people who feel healthy.

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2027 Part D Changes: Higher Cap, Higher Deductible, Subsidy Ending

Prescription drug coverage has the biggest rule changes this year. The annual out-of-pocket cap for covered drugs rises from $2,100 to $2,400. The maximum standard deductible goes to $700, up from $615 in 2026, though many plans charge less. CMS projects the average premium for a stand-alone drug plan will move from $35.09 to about $36.00, which is a small change on paper. The reason it is small is a bit awkward: the government’s temporary premium stabilization demonstration, which gave insurers a subsidy to hold premiums down, is ending after 2026, earlier than originally expected. Some individual plans may therefore still come in higher or lower than the average.

There is also good news for people who take certain high-cost medicines. Negotiated prices take effect on January 1 for 15 drugs, including Ozempic, Rybelsus and Wegovy, and the Associated Press reports that CMS projects the change will cut drug coverage costs by $685 million in 2027. Drugs such as Trelegy Ellipta, Xtandi, Ibrance and Otezla are also among those named in coverage of the changes. If you take any of these, check whether your plan lists them and what tier they sit on.

The 2027 figure for drug premiums inside Medicare Advantage plans is calculated after rebates the plans use, so it should not be added on top of the overall plan premium. Roughly 56.1 million people have Part D coverage: about 24.1 million in Original Medicare with a stand-alone plan, 3.4 million Advantage members with a stand-alone plan, and 28 million in Advantage plans that include drugs.

Medicare Advantage 2027: Fewer Plans, Fewer Counties, More Cost Sharing

The headline premium number looks friendly. CMS says the weighted average Medicare Advantage premium falls more than 16 percent, from $14.37 to $12.00. Reporters who cover the industry point out that the average is pulled down by special needs plans and does not reflect what many general enrollees will see. An industry-weighted estimate from Leerink Partners puts the average premium roughly flat, up about 1 percent. Plans that include drug coverage are expected to cost several dollars more per month on average, partly because there are fewer zero-premium choices.

Cost sharing is where people may be surprised. The average maximum out-of-pocket limit is expected to rise about 10 percent, and average Part D deductibles inside Advantage plans are up about 30 percent. A survey by HealthScape Advisors found nearly 70 percent of health plan leaders expect less generous benefit packages in 2027, with higher specialist copays and reduced dental coverage mentioned most often. David Lipschutz of the Center for Medicare Advocacy has said plans are leaving some areas, scaling back benefits and possibly raising what members pay.

Jeannie Fuglesten Biniek of KFF has noted that some disruption happens every year, but that the last two years have brought more than usual. Vivian Ho of Rice University and Baylor College of Medicine has said that people in cities and suburbs will likely still see many choices, while seniors in smaller rural areas may have the hardest time finding a plan. For some of them, Original Medicare may be the only practical option, which can cost more.

Medicare Part B 2027 Premium

The standard Part B premium is $202.90 in 2026. The Medicare Trustees projected $209.50 for 2027, which is $6.60 more, and a Part B deductible of about $292. These are projections until CMS publishes the official numbers, which normally happens in November. The projected increase is far smaller than the roughly 9.7 percent jump that took effect this year. For most people the premium is deducted from their Social Security payment, so it interacts directly with the 3.6 percent cost-of-living adjustment announced on October 14, which averages about $75 a month. A hold harmless rule limits how much a premium increase can cut a check, but it does not help new enrollees, people who pay premiums directly, or higher earners who pay an income-related surcharge.

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The $90 Medicare Payment: Who Gets It and Who Does Not

The administration announced a one-time $90 payment aimed at the Part B premium. CMS calls it a premium rebate, and Medicare Rights Center reports the money comes from the Medicare Improvement Fund, which Congress created in 2008 and which holds about $2 billion. The government says it will help more than 20 million enrollees. According to Medicare.gov, the payment offsets the Part B premium due in October 2026 and is made either by direct deposit or by a paper check mailed from the U.S. Treasury.

Nothing in the reports I reviewed says whether the payment is taxable, so check with a tax professional if that matters to you. The $90 covers less than half of this year’s $202.90 premium, and it is a single payment, not a recurring benefit. Medicare Advantage members who also pay Part B are excluded, which is the main reason roughly 35 million Medicare Advantage enrollees will not get it. You can read the official explanation on the Medicare.gov rebate letter page listed in the resource table below.

Medicare Open Enrollment Calculator

The calculator that comes with this article compares two common paths using your own numbers. Path one is Original Medicare with a Part D plan and an optional Medigap policy. Path two is a Medicare Advantage plan. Enter your Part B premium, the premiums for each option, what you expect to spend on care outside premiums, your expected drug spending, and the plan’s out-of-pocket maximum. The tool returns an expected yearly total and a worst-year total for each, so you can see both the likely cost and the downside. All the prefilled numbers are editable placeholders, not quotes, so replace them with figures from the Medicare Plan Finder and your Medigap quotes.

Here is an illustration with made-up inputs, only to show how the math behaves. Suppose Part B is $209.50 a month, a Medigap policy costs $150, a stand-alone drug plan costs $36, the Part B deductible is $292 and you expect $600 in drug costs. The expected total is about $5,638 a year. Now compare a Medicare Advantage plan with a $12 premium, $1,500 of expected medical spending and the same $600 in drug costs, which comes to about $4,758. In a bad year, the Medigap path is capped near $7,438, while the Advantage path with a $9,000 out-of-pocket maximum could reach about $14,058. The Advantage path is cheaper in the typical year and riskier in the worst one, which is often the real trade-off.

Original Medicare or Medicare Advantage: How to Decide

The choice comes down to predictability, access and flexibility. Original Medicare lets you see any provider that accepts Medicare and has no network, but it leaves 20 percent coinsurance and no yearly out-of-pocket limit unless you add a Medigap policy. Medicare Advantage usually has lower premiums, a yearly out-of-pocket limit and extras such as dental or vision, but it works through networks, may require referrals and can change benefits every year. If you are healthy and rarely see a specialist, an Advantage plan may cost less. If you have a complex condition, travel often or want your doctors to stay the same no matter what, Original Medicare with Medigap provides more certainty.

Before switching away from Advantage, understand the Medigap rules. In most states, insurers can review your health history when you apply for a Medigap policy outside of certain protected windows, and they may charge more or decline. Some states have extra protections. This is a real reason to talk to a counselor before leaving a plan you may want to return to.

How to Apply for or Change Medicare Coverage

You do not have to apply again if you are keeping your plan. To make a change, follow these steps.

1. Read your Annual Notice of Change. It shows next year’s premium, deductible, copays, network and formulary.
2. Check your doctors and drugs. Use the Medicare Plan Finder at medicare.gov/plan-compare and enter your exact prescriptions and pharmacy.
3. Compare totals, not just premiums. Include deductibles, copays and the out-of-pocket maximum.
4. Enroll in the new plan. You can do it online through the plan finder, by calling 1-800-MEDICARE at 1-800-633-4227, or by contacting the plan directly.
5. Keep the confirmation. Save the number or email, and watch for a welcome packet and a member card.
6. Do not cancel your old plan on your own. Enrolling in a new plan automatically ends the old one, and canceling first can leave you without coverage.

If you are new to Medicare and have not yet enrolled in Part A or Part B, Social Security handles those applications at ssa.gov/medicare. Free, unbiased help is also available from State Health Insurance Assistance Programs, which you can find at shiphelp.org or by calling 1-877-839-2675.

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Processing Time: When Will My New Plan Start?

Changes made by December 7 generally take effect on January 1, 2027. Many plans confirm your enrollment within days and mail a member ID in December or early January, but timing varies. If you enroll near the deadline, check your online account or call the plan before the new year to confirm everything went through. If you wait until after December 7 and your plan is not ending, you may be locked in until the next window, with limited exceptions. If your plan is leaving your area, you generally have a longer special window that runs through the end of February. Medicare Advantage members can also switch plans or go back to Original Medicare between January 1 and March 31, although that window does not allow you to move from Original Medicare into Advantage.

Medicare Payment Schedule: Premiums, the $90 Payment and Social Security

Money moves on a few different tracks. The Part B premium is usually deducted from your Social Security payment, so the new amount will show up in January if you receive benefits. If you are not yet receiving benefits, you get a bill instead, and you can pay by autopay, online or by mail. Advantage and Part D premiums can be deducted too, or billed by the plan. The one-time $90 payment is separate from all of these and is paid by direct deposit or a Treasury check to eligible Original Medicare enrollees. Social Security recipients should also watch the cost-of-living raise: SSI recipients see it on December 31, and most others see it in the payments delivered in January, with Wednesday dates of January 13, 20 and 27 depending on your birthday. You can also read your personal notice in your my Social Security account from late November, as long as you set up your account by November 18.

Last-Minute Checklist Before December 7

Open your plan’s Annual Notice of Change, and if it is missing, look at your plan’s website or call. Run your prescriptions through the Plan Finder, because a drug that sat on a low tier last year may have moved. Confirm that your key doctors and your preferred hospital are in the network for 2027. Compare the maximum out-of-pocket amount, not just the premium. Check whether your plan still includes dental, vision and hearing benefits that you actually use. If you pay a high Part B premium because of income and your situation has changed, you can ask Social Security to review it with Form SSA-44. Finally, ignore unsolicited phone calls offering to enroll you, and report anyone who asks for your Medicare number in exchange for a gift or a payment.

Official Medicare Open Enrollment Resources

Medicare Open Enrollment 2026 FAQs

Conclusion

Medicare open enrollment 2026 is more consequential than most years because plan options, drug costs and premiums are all moving at once. Mark December 7, read your plan’s notice, compare real totals instead of premiums alone, and use the calculator to see both the typical cost and the worst case. Keep an eye on the official Part B figure in November and on the 3.6 percent Social Security raise that helps cover it. When in doubt, a free counselor or the official Medicare line can answer questions that no article can. We’ll keep this page current as the official premiums and any new enrollment guidance arrive.