How to Prepare for Open Enrollment - Medicare and Medicare Advantage

How to Prepare for Open Enrollment - Medicare and Medicare Advantage

Key Dates & What the Period Covers

  • The annual Medicare Open Enrollment Period runs October 15 through December 7 each year. 

  • During this period you can:

    • Switch your Medicare health plan (for example between Original Medicare and a Medicare Advantage plan). 

    • Join, drop, or change your Medicare Part D prescription drug plan. 

    • Review and evaluate changes happening in your current plan (premiums, deductibles, network providers, drug formulary). 

  • If you do nothing and your plan is still offered, you may stay in it automatically—but you still should review because costs/coverage may change. 

🔍 Pre-Enrollment Preparation Steps

Here are key steps you should take before or during the OEP to make an informed decision.

1. Gather your current information

  • Collect the Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) your plan has sent—these will highlight what is changing next year. ncoa.org+1

  • Make a list of your doctors, specialists, hospitals you use, and pharmacies. Check whether they are in‐network for your plan next year.

  • Prepare a list of your medications (name, dose, frequency). Then check: Are they still on your plan’s drug formulary? Will their tier or cost change? healthpartners.com+1

  • Note your out‐of‐pocket costs this year (deductible met, copays, coinsurance, max out-of-pocket) and your anticipated needs for next year (e.g., new specialist visits, more prescriptions, travel).

2. Review how your needs may change

  • Ask yourself: Has my health status changed this year (new diagnosis, new medication, new specialist)?

  • Are my doctors or pharmacy relationships stable? Will I keep using the same providers, or will I need to switch?

  • Do I travel or live part‐time in another state or region where my plan network may not reach?

  • Will my medication regimen change next year (new drugs, higher quantities)?

  • Could my budget for premiums/copays change (income change, retirement, etc.)?

3. Compare your current plan vs alternatives

  • Using the gathered info (ANOC/EOC + list of providers + meds), compare whether your current plan still gives you the best value.

  • Use tools such as the official plan‐finder on Medicare.gov to compare local plans. Medicare

  • Consider other plan features beyond just premium: network of providers, quality ratings (star ratings), formulary coverage, out–of-pocket max, additional benefits (e.g., vision, dental, wellness). healthpartners.com

  • Be aware of star ratings (quality ratings) of plans, which may influence provider service experience. Investopedia+1

4. Decide whether to switch or stay

  • If your current plan still meets your needs in network + drugs + cost, staying may be easiest (just confirm it’s being offered next year).

  • If there are significant changes (higher cost, drug not covered, provider out of network) then consider switching.

  • If you’re comparing between Original Medicare + Part D + Medigap versus a Medicare Advantage plan, weigh trade-offs (e.g., flexibility vs networks, extra benefits).

5. Get trusted advice & set reminders

  • Consider consulting your State Health Insurance Assistance Program (SHIP) (free counseling) or a trusted licensed Medicare advisor. ncoa.org

  • Mark your calendar: October 15–December 7 is your window. Don’t procrastinate until the last week.

  • Set a deadline for yourself earlier (e.g., mid-November) so you have time to ask questions, compare, and not rush decisions.

  • Have your documents (ANOC/EOC, provider list, medication list, budget) ready well before the window opens.

___________________________________________________________________

Sample Agenda

  1. Before Oct 15:

    • Receive and review ANOC/EOC

    • Update provider/medication lists

    • Estimate next year’s healthcare needs + budget

    • Research plan options (premium, network, formulary)

    • Contact advisors/SHIP if questions

  2. Oct 15–Dec 7 (Enrollment Window):

    • Compare at least 2-3 plan choices

    • Check star ratings, quality, reviews

    • Choose plan that matches personal needs + budget

    • Enroll/switch by December 7 deadline

  3. After Enrollment (but before Jan 1):

    • Confirm enrollment accepted, check plan ID card arrival

    • Communicate with your doctors/pharmacy about new plan

    • Set up welcome visit/annual wellness visit if applicable

    • Update your budget/records for new year

  4. Effective Jan 1:

    • New plan coverage begins

    • Monitor for any unexpected changes in cost/coverage early in year – possible early plan change if needed (depending on situations)

    • Begin preparing/keeping file for next year’s review

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