October 21, 2021 · Financial Planning, Insurance, Retirement

Medicare Open Enrollment 2026: What to Review

Medicare open enrollment runs October 15 to December 7, 2026. Review key dates, what you can change, and how income can affect Medicare premiums.

Medicare open enrollment for the 2026 season runs October 15 to December 7, 2026. Changes to Medicare Advantage and Part D drug coverage made during that window generally take effect January 1, 2027. If you are already enrolled, reviewing your plan's notices before December 7 may help you spot changes that affect your costs or coverage.

Last updated October 11, 2026. As of October 11, 2026, Medicare.gov says the changes you make during Open Enrollment are effective January 1 of next year, and the plan must receive your enrollment request by December 7.[1] This guide is educational and is not a recommendation of any plan, carrier, or product. Individual circumstances vary, and your costs and coverage depend on the plans available where you live.

Medicare Open Enrollment Dates for 2026

As of October 11, 2026, Medicare.gov's yearly review guide lists these dates for the season that opens this month:[2]

October 1: Plans send notices about next year's costs and benefits, such as the Annual Notice of Change. It is a good time to read them.
October 15: Open Enrollment begins.
December 7: Open Enrollment ends. A health or drug plan must receive your enrollment form by this date.
January 1, 2027: New coverage begins, along with any changes to benefits or costs if you keep your current plan.
January 1 to March 31, 2027: If you are in a Medicare Advantage Plan, you may switch to a different Medicare Advantage Plan or to Original Medicare during this window. Changes are effective the first day of the month after the plan receives your form.

Can Anyone Make Changes During Open Enrollment?

Open Enrollment is for people who already have Medicare. If you have not yet signed up, your first chance is your Initial Enrollment Period, which lasts 7 months: it starts 3 months before the month you turn 65 and ends 3 months after the month you turn 65.[3]

If you miss that window, you generally cannot sign up for Part B during the October to December period. You may instead use the General Enrollment Period, which runs January 1 to March 31 each year. Coverage then starts the month after you sign up, and you might owe a monthly late enrollment penalty if you do not qualify for a Special Enrollment Period.[3]

If you are retiring before 65 and need to cover the gap, see our guide to health insurance before Medicare.

Are Changes Effective Immediately?

No. Changes made during Open Enrollment take effect January 1, 2027.[1] If you are satisfied with your current coverage and it is still offered, Medicare says you do not need to do anything, and your coverage continues automatically.[2]

What Can You Change During Open Enrollment?

What you can do depends on the coverage you have now.[1]

Medicare Advantage (Part C)

You can join, drop, or switch to another Medicare Advantage Plan, with or without drug coverage. You can also switch from a Medicare Advantage Plan back to Original Medicare. Medicare Advantage plans are offered by private companies approved by Medicare, and they bundle Part A and Part B and usually Part D.[2]

Medicare Part D (Prescription Drug Plan)

If you have Original Medicare, you can join, drop, or switch to another Medicare drug plan. Plan costs, covered drugs, and pharmacy networks can change each year, and so can your own prescriptions, so it is worth checking that your plan still fits for next year.[1][2]

Medicare Supplement Insurance (Medigap)

Medigap is extra insurance from a private company that helps pay your share of out-of-pocket costs in Original Medicare. Open Enrollment does not give you a general right to add, change, or drop a Medigap policy. Medicare.gov says there are limits on when you can add Medigap, including when you switch from a Medicare Advantage Plan back to Original Medicare.[1]

For many people, the key period is the one-time Medigap Open Enrollment Period, which starts once you sign up for Part B and lasts 6 months. Medicare.gov notes that its answers describe federal rights only, and your state may offer more opportunities.[4] Check with your State Insurance Department about the rules where you live. If you have a Medigap policy and join a Medicare Advantage Plan, you may not be able to get the same Medigap policy back later.[2]

How Can You Review Your Options?

Start with the materials your current plan sends, including the Annual Notice of Change and Evidence of Coverage, to see how costs and benefits may change in 2027.[2] Then use these official resources:

Medicare's Plan Finder tool lets you compare plans side by side and check your drugs, pharmacies, and doctors against each plan.
Call 1-800-MEDICARE (1-800-633-4227), available 24 hours a day, 7 days a week.
Contact your State Health Insurance Assistance Program (SHIP) for free, personalized counseling. Find your local program at shiphelp.org.

Questions to Ask Before You Decide

Are my current drugs, doctors, and pharmacies still covered next year, and at what cost?
How do the premium, deductible, and out-of-pocket costs compare, not just the monthly premium?
If I switch to a different type of coverage, can I switch back later, and under what rules?
Is my income likely to be higher or lower than usual in the next year or two, and could that affect my premiums?
Who in my household is turning 65 soon, and what is our enrollment timeline?

Potential Benefits and Trade-Offs of Changing Coverage

Potential benefit: A different plan may better match your prescriptions or providers. Trade-off: A new plan can have a different network, different rules, or different costs, and a change cannot always be reversed.
Potential benefit: Comparing plans each year can reveal cost or coverage changes you would otherwise miss. Trade-off: The comparison takes time, and the outcome depends on your health needs, location, and the plans offered, so savings are not assured.
Potential benefit: Keeping your current coverage requires no action. Trade-off: Your plan's costs and benefits may still change on January 1, so reading the annual notice remains worthwhile.

How Can Income Affect Your Medicare Premiums?

For households with large pre-tax retirement balances, Medicare choices connect to income planning. If your income is above certain levels, you pay an additional amount on top of your Part B and Medicare drug coverage premiums, known as the income-related monthly adjustment amount, or IRMAA.[5]

As of October 11, 2026, the Social Security Administration says it sets these amounts using your modified adjusted gross income (MAGI), which is your adjusted gross income plus tax-exempt interest income, from the most recent federal tax return the IRS provides. For 2026 premiums, that is generally the return for tax year 2024. For 2026, higher premiums apply when MAGI is above $109,000 for most filers, or above $218,000 for married couples filing jointly.[5] Amounts for 2027 premiums were not confirmed in the sources reviewed for this update, so check Medicare.gov and SSA.gov for current figures.

Because of that two-year lookback, income you report in one year can affect Medicare premiums later. Two common sources of taxable income in retirement are Roth conversions and required minimum distributions (RMDs). A Roth conversion adds the taxable amount to that year's income, and RMDs are generally taxable, so either may raise your income and could be one factor in a later year's premium. Our guides on Roth conversion pros and cons and how RMDs and Roth conversions interact explain each in more detail.

There is a trade-off in both directions. A conversion may reduce future required distributions, but it can raise income now. If your income drops because of a life-changing event, such as stopping work or the death of a spouse, SSA says you can ask it to make a new decision using Form SSA-44.[5][6] This is educational information, not a recommendation to convert, and tax decisions should be coordinated with a qualified tax professional.

How Does This Fit Into Retirement Planning?

Medicare decisions are one part of turning savings into retirement income. Our services cover retirement income, tax planning, and Social Security timing, the areas where Medicare costs may come into play. Our page on who I help describes the households I work with, and you can review how the firm charges on the fees page.

If you would like to talk through how Medicare fits into your plan, start with a 30-minute conversation.

Sources

All sources accessed October 11, 2026.