Medicare Annual Enrollment Checklist: What to Review Before December 7

Medicare Annual Enrollment is an important opportunity to review your healthcare coverage and determine whether your current plan still meets your needs. For 2026, the Annual Enrollment Period runs from October 15 through December 7, and changes generally take effect January 1, 2027.

Even if you are happy with your current coverage, an annual review can be worthwhile. Premiums, prescription drug coverage, provider networks, out-of-pocket costs, and other plan details can change from one year to the next.

Quick Answer: What Should You Review During Medicare Annual Enrollment?

Before December 7, consider reviewing:

• Your current Medicare enrollment
• Your plan’s Annual Notice of Change
• Prescription drug coverage
• Medication formularies and drug tiers
• Premiums and deductibles
• Provider networks
• Out-of-pocket maximums
• Medicare Advantage options
• Original Medicare and Medigap considerations
• Your potential IRMAA surcharge
• Eligibility for programs such as Extra Help

Most importantly, do not assume that your current plan will work exactly the same way next year.

When Is Medicare Annual Enrollment?

The Medicare Annual Enrollment Period runs from October 15 through December 7 each year.

During this period, Medicare beneficiaries generally have an opportunity to:

• Switch from Original Medicare to Medicare Advantage
• Switch from Medicare Advantage to Original Medicare
• Move from one Medicare Advantage plan to another
• Join a Medicare Part D prescription drug plan
• Switch Part D plans
• Drop Part D coverage

Changes made during Medicare Annual Enrollment generally take effect on January 1 of the following year.

Start by Confirming Your Medicare Coverage

Before comparing new plans, make sure you understand what you already have.

Confirm whether you are enrolled in:

• Medicare Part A
• Medicare Part B
• Medicare Part D
• Medicare Advantage
• A Medicare Supplement, or Medigap, policy

You can review your current Medicare information through your account at Medicare.gov.

Additionally, confirm that Medicare and your insurance plan have your current mailing address and contact information. Otherwise, you could miss important plan notices or coverage updates.

Review Your Annual Notice of Change

If you have Medicare Advantage or Medicare Part D coverage, your plan generally sends an Annual Notice of Change, commonly called an ANOC.

This document explains how your coverage will change for the upcoming year.

Pay particular attention to changes involving:

• Monthly premiums
• Deductibles
• Copays and coinsurance
• Prescription drug formularies
• Drug tiers
• Provider networks
• Pharmacy networks
• Out-of-pocket maximums
• Additional plan benefits

Instead of simply checking whether your premium increased, consider the total potential cost of your coverage.

Check Every Prescription You Take

Prescription coverage deserves its own review during Medicare Annual Enrollment.

A medication that was covered favorably this year may move to a different tier next year. Additionally, a drug could be removed from a plan’s formulary or become subject to different coverage requirements.

Create a current medication list that includes:

• Medication name
• Dosage
• Frequency
• Preferred pharmacy
• Current copay or coinsurance

Then compare your medications against the upcoming year’s plan formulary.

This step can be especially important if you take several medications or use higher-cost prescriptions.

Understand the Medicare Part D Out-of-Pocket Limit

Prescription drug coverage has changed significantly in recent years.

Beginning in 2025, Medicare Part D introduced a $2,000 annual out-of-pocket cap for covered Part D drugs. For 2026, that annual limit increases to $2,100. Once you reach the applicable out-of-pocket threshold for covered Part D drugs, you generally pay $0 for covered Part D drugs for the remainder of the calendar year.

The source checklist specifically highlights the $2,100 limit as an important item to consider when reviewing 2026 prescription coverage.

However, premiums and certain costs that do not count toward the Part D out-of-pocket limit can still affect your total healthcare spending.

Compare Total Prescription Costs, Not Just Premiums

The lowest-premium Part D plan is not necessarily the least expensive plan for you.

For example, a plan with a slightly higher monthly premium could provide better coverage for the medications you take. Meanwhile, a lower-premium plan could have a higher deductible, different drug tiers, or higher copays.

Therefore, compare your estimated total annual cost, including:

• Premiums
• Deductibles
• Copays
• Coinsurance
• Expected prescription costs

This approach can provide a more useful comparison than looking at premiums alone.

See Whether You Qualify for Extra Help

Medicare’s Extra Help program assists eligible individuals with certain Medicare Part D costs.

Depending on eligibility, Extra Help can reduce costs related to:

• Part D premiums
• Deductibles
• Prescription copays or coinsurance

Income and resource requirements apply.

If your financial circumstances have changed, do not assume that a previous eligibility determination still applies. You can learn more about Extra Help through Medicare.gov.

Review Your Income for IRMAA

Your income can affect what you pay for Medicare Part B and Part D.

The Income-Related Monthly Adjustment Amount, or IRMAA, is an additional amount some higher-income Medicare beneficiaries pay for Part B and Part D.

Importantly, Medicare generally determines IRMAA using tax information from two years earlier. Therefore, the income Medicare sees may not reflect your current financial situation.

This can become particularly important after retirement.

What If Your Income Has Dropped Since Retirement?

If your income has decreased because of certain life-changing events, you may be able to ask Social Security to reconsider your IRMAA determination.

Qualifying events can include circumstances such as:

• Retirement or work stoppage
• Reduction in work
• Marriage
• Divorce or annulment
• Death of a spouse
• Loss of certain income-producing property
• Loss of certain pension income
• Employer settlement payments

Social Security uses Form SSA-44 for requests based on certain life-changing events and reduced income.

Therefore, if you recently retired and your current income is substantially lower than the tax return being used for IRMAA, it may be worth reviewing the Social Security Administration’s current rules.

Compare Original Medicare and Medicare Advantage Carefully

Medicare Annual Enrollment also provides an opportunity to reconsider how you receive your Medicare coverage.

Original Medicare and Medicare Advantage work differently.

With Original Medicare, beneficiaries may choose to purchase a separate Part D prescription drug plan and may also consider a Medigap policy.

Medicare Advantage plans, meanwhile, are offered by private insurance companies approved by Medicare and typically combine Part A and Part B coverage. Many also include Part D prescription coverage and may offer additional benefits.

When comparing options, consider more than the monthly premium.

Review Medicare Advantage Provider Networks

If you have or are considering Medicare Advantage, check whether your preferred healthcare providers will participate in the plan next year.

Review your:

• Primary care physician
• Specialists
• Hospitals
• Medical groups
• Pharmacies
• Other frequently used providers

Additionally, determine whether referrals or prior authorizations apply.

A plan can look attractive based on premiums and benefits but may be less useful if your preferred providers are outside its network.

Check the Medicare Advantage Out-of-Pocket Maximum

Medicare Advantage plans have annual limits on certain out-of-pocket costs for covered Part A and Part B services.

However, those limits can vary by plan.

Therefore, do not compare Medicare Advantage plans based only on monthly premiums. Consider deductibles, copays, coinsurance, provider networks, prescription coverage, and the plan’s maximum out-of-pocket exposure.

If you expect significant healthcare use, these details may become especially important.

Be Careful When Moving Between Medicare Advantage and Medigap

Medicare Advantage and Medigap are different types of coverage.

A Medigap policy supplements Original Medicare. It cannot be used together with Medicare Advantage.

Additionally, your ability to purchase a Medigap policy without medical underwriting can depend on federal guaranteed-issue protections and state-specific rules.

As a result, do not assume that leaving Medicare Advantage automatically guarantees access to any Medigap policy you want.

Review your eligibility before making a coverage change.

Know About Medicare Advantage Open Enrollment

If you are already enrolled in Medicare Advantage, you have another enrollment period after the fall Annual Enrollment Period ends.

The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 each year.

During that period, people already enrolled in Medicare Advantage can generally make one change to another Medicare Advantage plan or return to Original Medicare.

However, this period is not a second general Medicare Annual Enrollment window. Different rules apply depending on your existing coverage.

Review Your Medicare Part B Premium

Healthcare budgeting should include your Medicare premiums as well as your plan-specific costs.

For 2026, the standard Medicare Part B monthly premium is $202.90. Higher-income beneficiaries may pay more because of IRMAA.

Additionally, Medicare Part B premiums are generally separate from Medicare Advantage, Medigap, and Part D premiums.

Therefore, calculate your total expected monthly healthcare premiums rather than evaluating each policy separately.

Remember That Part D IRMAA Is Separate From Your Plan Premium

If IRMAA applies to your Medicare Part D coverage, the surcharge is separate from the premium charged by your prescription drug plan.

The Part D IRMAA amount is generally paid to Medicare rather than to your insurance plan.

Consequently, your total prescription coverage cost may include both:

• Your Part D plan premium
• Your applicable Part D IRMAA amount

Understanding the difference can help prevent confusion when reviewing premium notices.

Don’t Assume Your Current Plan Is Automatically Your Best Choice

If you make no changes during Medicare Annual Enrollment, your current coverage may generally continue into the next year as long as the plan remains available and you continue to meet its requirements.

However, automatic renewal does not mean the plan remains unchanged.

Premiums can increase. Provider networks can change. Prescription formularies can change. Copays and deductibles may also change.

Therefore, reviewing the new plan details each year can help you make a more informed decision.

For more educational resources about Medicare, retirement, taxes, and financial planning, visit the Holland Strategic Wealth Advisors blog.

Your Medicare Annual Enrollment Checklist

Before the December 7 deadline, work through these steps:

• Confirm your current Medicare enrollment.
• Review your Annual Notice of Change.
• Update your medication list.
• Check next year’s drug formulary and tiers.
• Compare estimated annual prescription costs.
• Review your preferred doctors and hospitals.
• Compare Medicare Advantage provider networks.
• Check deductibles, copays, and out-of-pocket maximums.
• Review your Part B premium.
• Determine whether IRMAA applies.
• Consider whether an income change could support an IRMAA reconsideration.
• Check whether you qualify for Extra Help.
• Review Medigap eligibility before leaving Medicare Advantage.
• Submit any desired coverage changes by December 7.

The checklist supplied for this article similarly emphasizes confirming enrollment, reviewing prescription coverage, comparing supplemental options, checking upcoming costs, and completing changes before the enrollment deadline.

Frequently Asked Questions About Medicare Annual Enrollment

When is Medicare Annual Enrollment?

Medicare Annual Enrollment runs from October 15 through December 7 each year. Coverage changes made during this period generally take effect January 1 of the following year.

Do I need to do anything if I want to keep my current Medicare plan?

Your coverage may renew automatically if your plan continues to be offered. However, review the Annual Notice of Change because premiums, benefits, prescription formularies, provider networks, and other costs can change.

What should I compare when reviewing Medicare plans?

Compare more than premiums. Consider deductibles, copays, coinsurance, prescription coverage, provider networks, pharmacies, out-of-pocket limits, and your expected total annual healthcare costs.

What is IRMAA?

IRMAA stands for Income-Related Monthly Adjustment Amount. It is an additional amount that higher-income Medicare beneficiaries may pay for Part B and Part D. Medicare generally uses tax information from two years earlier when determining the surcharge.

What is the 2026 Medicare Part D out-of-pocket limit?

For 2026, the annual out-of-pocket limit for covered Part D drugs is $2,100. Once you reach that threshold, you generally pay $0 for covered Part D drugs for the rest of the calendar year.

Holland Strategic Wealth Advisors offers insurance products and services. We are not affiliated with or endorsed by the U.S. Government or any governmental agency. References to Medicare are for general informational purposes only. Holland Strategic Wealth Advisors and its agents do not offer Medicare Advantage, Medicare Supplement, or Part D plan enrollment services unless specifically licensed and appointed to do so. For Medicare-specific guidance, visit Medicare.gov or contact 1-800-MEDICARE (1-800-633-4227). This information is not intended to provide financial, legal, or tax advice and does not address an individual’s specific circumstances. Investing involves risk, including possible loss of principal. Insurance product guarantees are backed by the financial strength and claims-paying ability of the issuing company.