Medicare Open Enrollment Ends December 7. Here's What the Mailers Don't Tell You.
If you're on Medicare, your mailbox has probably been busy lately. Brochures, postcards, a phone call or two. They all point to the same deadline.
Medicare's annual open enrollment runs from October 15 through December 7. It's the one window each year when anyone on Medicare can switch Medicare Advantage plans, change Part D prescription drug plans, or move between Original Medicare and Medicare Advantage. Whatever you choose takes effect January 1.
The mailers do a good job of telling you what's new. Here are a few things they usually leave out.
"I'll just keep what I have" is still a decision
Plans can change every year. Premiums, deductibles, copays, which drugs are covered, and which doctors and pharmacies are in network can all shift on January 1.
Your plan is required to send you an Annual Notice of Change each fall that spells this out. It isn't exciting reading, but it's the most important piece of mail in the stack. If you can't find yours, call the plan and ask for another copy.
The premium isn't the whole cost
A plan with a low or $0 premium can still cost more over a full year than one with a higher premium. It depends on what you take and who you see.
When comparing plans, I'd look at:
→ Your total yearly cost: premium, plus deductibles and copays for the prescriptions you actually take
→ Whether your doctors, specialists, and preferred pharmacy are in network
→ Any prior authorization or step therapy rules on your medications
→ How the plan covers care when you travel or spend part of the year away from home
The Plan Finder tool at Medicare.gov lets you enter your prescriptions and compare plans side by side. It takes a little time to set up, and it's time well spent.
Switching back isn't always simple
You can leave Medicare Advantage for Original Medicare during open enrollment. But if you also want a Medicare Supplement (Medigap) policy, the insurer may be allowed to ask health questions and charge more or turn you down, outside of certain guaranteed situations. The rules vary by state.
That's why this choice deserves extra thought, especially if your health has changed since you first signed up.
Your income from two years ago affects your premium
This one surprises people the most. Higher-income retirees pay more for Part B and Part D through an income-related adjustment, often called IRMAA. Medicare generally uses your tax return from two years earlier, so your 2027 premiums will be based on your 2025 income.
That matters for anyone who had a one-time spike in income: selling land or equipment, a large Roth conversion, a big capital gain, or the year you sold a business. For farm and ranch families and business owners, those years aren't unusual.
If your income has dropped because of a major life change, such as retiring or losing a spouse, you can ask Social Security to use more recent income. And it works the other way too: decisions you make this year can show up in your Medicare premiums in 2028.
A short checklist before December 7
- Find and read your plan's Annual Notice of Change.
- Make an updated list of your prescriptions, doses, doctors, and pharmacy.
- Compare plans at Medicare.gov, or get free, unbiased help from Kansas's SHICK program (Senior Health Insurance Counseling for Kansas).
- Look back at your 2025 income for anything unusual that could affect 2027 premiums.
- In early January, confirm your new cards arrived and your coverage is what you expected.
If you're in a Medicare Advantage plan and change your mind, there's a second, more limited window from January 1 through March 31. Still, it's better to get it right the first time.
Medicare decisions are rarely one-size-fits-all. The right plan for your neighbor may not be the right one for you, and the cheapest premium isn't always the lowest cost.
If you or your parents are sorting through options this fall, or wondering how this year's income decisions could affect future premiums, I'm always happy to talk it through.
This information is not intended to be a substitute for specific individualized guidance on Medicare plans or supplemental Medicare options; please consult a licensed Medicare insurance agent for plan-specific guidance.