Medicare Open Enrollment: changing plans each fall

If you already have Medicare, there is one window each year to change plans: October 15 to December 7, and what you choose in that window takes effect on January 1 of the next year. Outside it, most people cannot change until the following fall. This guide covers what you can change, what the September letter from your plan says, who helps for free in Vietnamese, and what the law forbids a salesperson from doing.

This page does not sell insurance, is not connected to any insurer or plan, and does not pick a plan for you. Its job is to set out the mechanism and the dates so you can choose, or ask the right free source for help.

What you can change during this period#

Medicare's enrollment page lists exactly three groups of moves for October 15 to December 7:

• Join, drop, or switch to another Medicare Advantage Plan, with or without drug coverage, including adding or dropping the drug coverage part.
• Switch from Original Medicare to a Medicare Advantage Plan, or from a Medicare Advantage Plan back to Original Medicare.
• Join, drop, or switch a Part D drug plan, if you are in Original Medicare.

One line on that page is worth underlining: the plan must receive your request by December 7. December 7 is the deadline for the plan to have your request, not the deadline for you to put it in the mail. Enrolling online or by phone confirms it arrived; a paper form has to allow for postal time.

The three ways to join that Medicare lists: select "Enroll" for the plan you want in the plan comparison tool, contact the plan directly by phone or on its website, or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.

Do not ring up to cancel the old plan separately. Medicare's page on switching drug coverage says "your old drug coverage will end when your new drug coverage begins", that the new plan will send you a letter telling you when coverage begins, and therefore "you don't need to cancel your old plan." Dropping a plan without joining one is the route into 63 days without drug coverage and the permanent penalty described below. Keep the new plan's confirmation letter, and if January arrives with no card, ring the plan rather than waiting until you need a prescription.

What the September letter says, and why it decides this#

Each fall your plan will send you a letter called the Annual Notice of Change (ANOC) covering every change in coverage, costs and more that "will be effective in January." Many people assume that not changing plans means there is nothing to do; but the plan can change while you stay put, and that letter is the only place it says so in advance.

Medicare's page about this letter says it arrives in September (checked September 30, 2026), is sent by your plan, and that what you should do with it is review the changes to decide whether the plan will continue to meet your needs next year. It adds one short but important line: if you do not get that letter, contact your plan.

Three parts of the letter to read first, because they are the parts that decide whether the plan still works for you: the monthly cost, the list of covered drugs and what you pay for each, and the list of in-network doctors and pharmacies. A plan that keeps the same name next year can still drop the drug you take off its list, or drop the doctor you see out of its network.

Original Medicare or Medicare Advantage: where they differ#

This is the part a salesperson moves through quickly, and the part worth reading slowly. Medicare.gov's comparison page lists these differences, and they are differences in how the coverage works, not a statement that one is better:

• Doctors and hospitals. Original Medicare: you can use any doctor or hospital that takes Medicare, anywhere in the US. Medicare Advantage: in most cases you must use doctors in the plan's network and service area for non-emergency care; some plans cover out-of-network care but it may cost more.
• Referrals. Original Medicare: in most cases you do not need a referral to see a specialist. Medicare Advantage: you may need one.
• Prior approval. Original Medicare: in most cases no approval is needed before a service is covered. Medicare Advantage: you may need prior authorization from the plan for certain services.
• Yearly out-of-pocket limit. Original Medicare: there is no yearly limit, unless you have supplemental coverage such as Medigap, Medicaid, or employer coverage. Medicare Advantage: plans do have a yearly limit, and the page says that once you reach your plan's limit you pay nothing for covered services for the rest of the year.
• The monthly premium. Original Medicare: you pay the Part B premium each month, plus a separate Part D premium if you add a drug plan. Medicare Advantage: the page says you pay the monthly Part B premium and may also pay the plan's premium; some plans have a $0 premium and some help pay part or all of your Part B premium. In other words, a plan advertised as "$0 a month" does not mean nothing to pay: the Part B premium keeps running.
• Medigap. While you are in a Medicare Advantage Plan you cannot buy Medigap to cover your out-of-pocket costs.
• Extra benefits. A Medicare Advantage Plan must cover all medically necessary services that Original Medicare covers, and may add benefits Original Medicare does not cover, such as some vision, hearing and dental care. If an extra benefit is advertised to you, look for it in the plan's own documents and in Medicare's plan comparison tool rather than relying on the advertisement or on what a salesperson says.

Where drug spending stops, and whether it can be spread out#

Out-of-pocket spending on drugs in 2026 stops at 2,100 dollars, and the year's drug costs can be spread across the months at no extra cost. Those are the two things about Part D to know before comparing plans.

First, there is a cap. Medicare's costs page states that out-of-pocket spending on drugs in 2026 stops at 2,100 dollars, and that the total includes your deductible, your own out-of-pocket spending, and certain payments made on your behalf, such as through Extra Help.

Second, there is a way to spread it out. Medicare's page on the Medicare Prescription Payment Plan describes it as a payment option that spreads your out-of-pocket drug costs across the calendar year, January through December. Anyone with a Medicare drug plan or a Medicare health plan with drug coverage can use it, all plans must offer it, participation is voluntary, and there is no cost to participate. But the page says plainly what a salesperson rarely mentions: the option "doesn't save you money or lower your drug costs." It only evens out the monthly bill.

If your income is low: Extra Help, and the 2026 numbers#

Medicare's drug-costs page describes Extra Help as a program that helps people with limited income and resources pay Part D premiums, deductibles and coinsurance. Two things are worth remembering: while you get Extra Help you do not pay the Part D late enrollment penalty, and some people qualify automatically without applying.

You get it automatically if you have full Medicaid coverage, if your state pays your Part B premium through a Medicare Savings Program, or if you receive SSI.

The income and resource limits the page gives for 2026:

• Individual: income up to 23,940 dollars, resources up to 18,090 dollars.
• Married couple: income up to 32,460 dollars, resources up to 36,100 dollars.

Note that this page deliberately mixes two years, and mixes them correctly: the income and resource limits above are 2026 limits, used to decide whether you qualify, while what you will pay is already published for 2027: a $0 plan premium, a $0 deductible, up to $5.80 for each generic drug and up to $14.40 for each brand-name drug at a participating pharmacy, and once your total drug costs (including certain payments made on your behalf, such as through Extra Help) reach $2,400, $0 for each covered drug for the rest of the year. Someone with full Medicaid who is in the QMB program pays no more than $4.90 per covered drug. The $2,400 and the $2,100 are not the same measure: $2,100 is the 2026 Part D out-of-pocket cap, while $2,400 is a 2027 total drug cost threshold inside Extra Help.

The page notes the income and resource limits may rise each year and that Alaska and Hawaii have their own. If you do not qualify automatically, you apply, and your state's SHIP program helps you apply for free. Applying for Extra Help is also the moment to be screened for Medicare Savings Programs: the page says Social Security will send information to your state to start an MSP application unless you tell them not to on the Extra Help application.

What people selling plans are not allowed to do#

This is the section to read with your parents. Medicare.gov's marketing rules page lists what people representing Medicare plans cannot do. Some of that list:

• Ask for your personal information such as bank account or credit card numbers over the phone, unless it is needed to process an enrollment request. The page says directly that plans "don't need your personal information to give a quote."
• Come to your home uninvited to sell or endorse anything.
• Call you unless you are already a member of the plan or have given permission to contact you.
• Require you to speak to a sales agent to get information about the plan.
• Offer you cash, or gifts worth more than 15 dollars, to join their plan, or give you free meals during a sales pitch.
• Ask you for payment over the phone or online. The page says the plan must send you a bill.
• Sell you a non-health related product, like an annuity or life insurance policy, during a sales pitch for a Medicare plan.
• Talk to you about their plan in areas where you get health care, like an exam room, a hospital room, or a pharmacy counter.
• Advertise without using specific plan names, or advertise using confusing words or images or misleading Medicare logos.

For a meeting with an agent, the page adds what they cannot do during it: charge you a fee to process your enrollment, steer you into a particular plan, use statements like their plan is "the best" or "highest ranked", tell you about plan options you did not agree to discuss, pressure you with lines like "you have to join this plan or you won't have coverage next year", ask for the names and phone numbers of your friends and family so they can sell to them, or ask you to sign the enrollment form before you are ready. The page says it plainly: only sign when you are ready to join.

The page also notes that independent agents and brokers must be licensed by the state, and the plan must tell the state which agents are selling its plans. And if you made the wrong plan choice because of inaccurate or misleading information, the page says to call 1-800-MEDICARE and explain your situation, because representatives there "can help you throughout the year with options for making changes."

Who helps for free, and who helps in Vietnamese#

These routes, none of them selling you anything:

• The right to an interpreter at the clinic, not just on Medicare's phone line. Your right to a free interpreter covers whose duty it is, how to ask, and where to complain within 180 days if you are refused.
• 1-800-MEDICARE (1-800-633-4227), and ask for an interpreter. Medicare's language page says you have the right to get Medicare information in the language you prefer, that you call this number and ask for an interpreter, and that the line runs 24 hours a day, 7 days a week, except some federal holidays. TTY 1-877-486-2048.
• Your state's SHIP. Medicare says State Health Insurance Assistance Programs help people with Medicare and their families choose a plan, review coverage, understand costs, apply for Extra Help, and file a complaint or an appeal. It states plainly that SHIPs "aren't connected to any insurance company or health plan", and that is the core difference between a SHIP counsellor and a salesperson. If you do not know your state's SHIP number, call 1-800-MEDICARE, ask for a Vietnamese interpreter, and ask for it.
• For a child or relative calling on your behalf: there is a form. Medicare will not discuss your records with someone else without permission. Medicare's forms page lists Authorization to Disclose Personal Health Information (CMS-10106), used for "giving Medicare permission to talk to someone you choose about your claims and health records, if you can't." Filling it in first is how an adult child avoids being stopped at the first question. That page covers Medicare's own form only; for a private plan, ask the plan what it needs. The faster route within a single call: the parent dials, gives permission, and hands the phone over.
• If you were sold the wrong plan, or suspect fraud, there is a separate number. Medicare's fraud page says to call 1-800-MEDICARE or report online, and that if you have a Medicare Advantage Plan or drug plan you can also call I-MEDIC on 1-877-7SAFERX (1-877-772-3379). Two lines from the same page are worth reading with the whole family: "Medicare will never call you to sell you anything or visit you at your home", and on its list of things not to do: do not join a Medicare health or drug plan over the phone unless you rang and asked for help.
• Medicare's own Vietnamese-language material. medicare.gov/publications has a language drop-down that filters for Vietnamese. Two that exist today: understanding Medicare Advantage Plans and the Medicare Prescription Payment Plan.

If December 7 passes#

Medicare's enrollment page names two routes after that:

• The Medicare Advantage Open Enrollment Period, January 1 to March 31. Only for people already in a Medicare Advantage Plan. In it you can switch to a different Medicare Advantage Plan, or drop the plan and return to Original Medicare, and on returning you may also join a separate drug plan. Coverage starts the first of the month after the plan gets your request. Do not confuse this with the General Enrollment Period, which also runs January 1 to March 31 but is for people signing up for Medicare for the first time (covered in Medicare for seniors who are new to the US). Same dates, different people.
• A Special Enrollment Period. The page says these vary by situation. The ones this guide's readers meet most, straight off that page:
  • Your plan's contract with Medicare is not renewed. You can switch between December 8 and the last day of February the following year — a window that opens after December 7. The page adds that if you do not join another Medicare Advantage Plan before the old one ends, you will be enrolled in Original Medicare.
  • You have Medicaid, or you get Extra Help. The page says you "can make changes to your coverage once a calendar month", effective the first day of the next month, and notes immediately below that "most people with Medicare can only make changes to their drug coverage at certain times of the year." Note the scope, because this is easy to read too widely: everything the page permits in this window is drug coverage, switching to a different Medicare drug plan, or dropping an Advantage plan with drug coverage and returning to Original Medicare by joining a stand-alone drug plan. It does not permit moving from one Medicare Advantage Plan to another every month. So for this group December 7 is not the deadline for drug coverage. One exception: the right does not apply to anyone the plan has identified as "at-risk" or "potentially at-risk" under a Part D drug management program, and the plan has to write to you if it does.
  • Moving out of the plan's service area. You get 2 full months after the move. And one detail worth money: the page says that if you tell the plan before you move, the window starts the month before the month you move, so it is longer.
  • Moving back to the US after living abroad. The page names this situation directly: you can join a Medicare Advantage Plan or drug plan within 2 full months after the month you move back.
  • Two income-related ones: losing Medicaid eligibility and learning you will not qualify for Extra Help next year each give 3 full months, counted from the date you lost eligibility or the date you were told, whichever is later.

Next steps#

1. Find your plan's ANOC letter, which arrives in September. If it did not come, call the plan rather than waiting.
2. Write down the drugs you take, the doctors you see, and the pharmacy you use. Step 2 of Medicare's enrollment page asks you to weigh both sides: monthly premiums and deductibles, plus the estimated yearly cost of exactly the drugs you take.
3. Compare plans at medicare.gov/plan-compare, entering every drug you take so the yearly estimate is realistic.
4. If your income is low, get screened for Extra Help and a Medicare Savings Program in the same sitting.
5. If you need Vietnamese, call 1-800-MEDICARE and ask for an interpreter, or book your state's SHIP. Both are free.
6. Decide before December 7, allowing time for the plan to actually receive your request.