Medicare Enrollment 2026: What You Need to Know Before October
The Annual Enrollment Period brings key changes every year. Here's what every beneficiary should review — and what most people miss.
The Annual Enrollment Period (AEP) runs from October 15 through December 7. During this window, you can switch Medicare Advantage plans, change Part D prescription drug plans, or move between Original Medicare and Medicare Advantage.
If you do nothing, your current plan renews automatically. That sounds convenient — but it's how most people end up overpaying or under-covered.
Why You Should Review Every Year
Even if you're happy with your current plan, three things change annually:
- Premiums and cost-sharing. Your plan's monthly premium, deductibles, copays, and out-of-pocket maximums can all change.
- Drug formularies. The medications your plan covers — and what tier they're on — change every year. A drug that cost $15 last year might cost $45 this year.
- Provider networks. Doctors and hospitals can leave or join networks. Your preferred doctor might not be in-network next year.
Key Changes for 2026
Several important updates take effect for the 2026 plan year:
- Part D redesign continues. The Inflation Reduction Act's $2,000 annual out-of-pocket cap on prescription drugs is now in full effect. If you're on expensive medications, this could save you thousands.
- Medicare Advantage plan changes. CMS star ratings have shifted, affecting which plans receive bonus payments. Some plans may reduce benefits or exit certain counties.
- Part B premium adjustment. The standard Part B premium adjusts annually based on Medicare spending projections. Check Medicare.gov for the current year amount.
- Income-Related Monthly Adjustment Amount (IRMAA). If your modified adjusted gross income exceeds certain thresholds, you'll pay higher Part B and Part D premiums. Review your income from two years ago — that's what Medicare uses.
💡 Don't assume your plan is still the best option.
We review plans for clients every year and regularly find savings of $50–$200/month — or better coverage at the same price. A 15-minute review can save you thousands annually.
Your Pre-AEP Checklist
- Review your Annual Notice of Change (ANOC). Your plan mails this by September 30. It lists every change for next year. Actually read it.
- Update your medication list. Make sure you have current names, dosages, and frequencies for everything you take.
- Confirm your doctors are still in-network. Call your plan or check online. Don't assume.
- Check the Medicare Plan Finder. Go to Medicare.gov and compare plans using your actual medications and doctors.
- Talk to an independent broker. We can compare plans across all available carriers in your area — for free.
Common Mistakes to Avoid
- Doing nothing. Auto-renewal isn't a strategy. Plans change. Your health changes. Review annually.
- Choosing the lowest premium. A $0 premium plan with high copays and a narrow network can cost you more than a $50/month plan with better coverage.
- Ignoring the donut hole. Even with the new $2,000 cap, understanding your drug costs through the coverage gap matters for budgeting.
- Missing the deadline. AEP ends December 7. If you miss it, you're locked into your current plan until next year (with limited exceptions).
Need Help Comparing Plans?
Balcones Advisors offers free, no-obligation Medicare plan reviews. We'll compare your current coverage against every available option in your area and help you make the right choice — not just the easiest one.
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