3 Things You Need to Know About Medicare Advantage's Open Enrollment Period

Think of your Medicare coverage like a yearly subscription. The Open Enrollment period is your annual chance to review and adjust that subscription before it automatically renews. It runs from October 15 to December 7, and any changes you make during this window take effect on January 1 of the next year. The plan must receive your enrollment request by December 7 to make it official.

During this time, you have three main actions you can take, depending on your current coverage:

1. Switch Medicare Advantage Plans: If you're in a Medicare Advantage plan (a private plan that bundles your Part A and B benefits), you can join a different plan, drop your current one, or switch to another plan with or without prescription drug coverage. You can also add or drop drug coverage if you're already in a plan that offers it.

2. Change Your Drug Plan: If you're in Original Medicare, you can join, drop, or switch to a different Medicare Part D prescription drug plan.

3. Switch How You Get Coverage: You can move between Original Medicare and a Medicare Advantage plan. This is a significant change, so it's important to understand the implications. If you're switching from a Medicare Advantage plan to Original Medicare, you'll need to take extra steps. You'll have to join a separate drug plan to cover your prescriptions, and you may want to consider adding Medicare Supplement Insurance (Medigap). Medigap acts like a safety net, helping to pay your share of out-of-pocket costs like deductibles and copays that Original Medicare doesn't cover. Keep in mind there are specific times when you can buy Medigap, so it's wise to plan ahead.

The key is to act during this window. If you wait, your coverage will simply roll over, and you might miss out on a plan that better fits your needs or budget.

What's Changing in 2026: Choices, Costs, and Coverage

The landscape for Medicare Advantage is shifting in subtle but important ways for 2026. For beneficiaries, the most immediate change is a slight narrowing of choice. The average beneficiary now has 32 Medicare Advantage prescription drug plans available, a two-plan decrease from 2025. This reflects a broader trend of plan consolidation, with the total number of individual Medicare Advantage plans nationwide dropping by about 9%.

Yet, even as overall plan counts dip, the market is diversifying in a different direction. While total Medicare Advantage enrollment is projected to decline to 34 million, a key segment is growing rapidly: Special Needs Plans (SNPs). These plans cater to specific populations, like those with chronic illnesses or institutionalized individuals, and their numbers are expanding. This growth means more specialized options for those who qualify, even as the general pool of plans shrinks.

The third major shift is in the value proposition. The extra benefits that make Medicare Advantage so popular-like dental and vision-remain widely available, with nearly all individual plans offering vision, dental, and hearing benefits. But the trade-off is becoming more pronounced. As plans compete on cost, they are often tightening their provider networks and scaling back on certain supplemental perks. For instance, the share of plans offering transportation services or over-the-counter item allowances has declined. In other words, the "free" extras are still there, but they come with more restrictions on where and how you can use them.

The bottom line for 2026 is a market in transition. You have fewer plans to choose from, but more specialized options are emerging. The core promise of extra benefits at no extra premium remains, but it's increasingly tied to a more limited network of doctors and hospitals. This makes comparing plans not just about premiums, but about the specific doctors you need and the services you rely on.

Navigating the Risks: Plan Termination and Access Issues

While the Open Enrollment period gives you control, two specific risks are on the rise for 2026. The first is disruption from plan changes. Nearly 1.3 million beneficiaries are facing the end of their current Medicare Advantage plan or a move to a different plan within the same insurer. This isn't a minor administrative shift; it's a potential change in your doctor's office, pharmacy, and even your out-of-pocket costs. The good news is that if your plan ends, you'll be automatically moved to another plan with the same insurer. But that new plan could have a different network of doctors and hospitals, or different rules for covering your prescriptions. The key preparation step is to review the details of your new plan carefully, especially the provider list, before the year starts.

The second risk is more subtle but equally important: how plans are promoted. As insurers focus on profitability, they are cutting back on unprofitable plans. According to data, insurers have cut broker commissions on 15% to 20% of plans to discourage enrollment in these less desirable products. This means some of the plans you might want to consider could be less visible or less aggressively promoted by your insurance agent or broker. It's a reminder to do your own homework, not just rely on the first recommendation you get.

The bottom line is that 2026 is a year of consolidation and cost control for Medicare Advantage. The risks of plan termination and access issues are real, but they are manageable with a bit of proactive effort. Use this Open Enrollment period to understand the specifics of any plan you're considering, and don't hesitate to ask questions about networks and costs. Being informed is the best way to protect your coverage and your care.