Medicare Open Enrollment Is Almost Here: 7 Things Retirees Should Review Before They Renew Anything

By Scott Searles  |  October 9th, 2026

Medicare Open Enrollment begins October 15 and runs through December 7, 2026.

For many retirees, the easiest choice will be to do nothing.

Your current plan worked this year, so why change it?

Because your plan may be changing even if you aren’t.

Prescription coverage can change.

Provider networks can change.

Premiums and deductibles can change.

Pharmacies can move into different pricing arrangements.

And a plan that worked well for you in 2026 may not necessarily be your best fit in 2027.

CMS recently projected relatively stable Medicare Advantage and Part D markets overall for 2027. But national averages don’t tell you what is happening with your specific plan, your prescriptions, your doctors, or your household budget.

That’s why I believe retirees should treat Medicare Open Enrollment as an annual financial review—not simply an insurance renewal.

Here are seven things I would look at before automatically keeping the same coverage.

1. Start With Your Annual Notice of Change

If you’re enrolled in a Medicare Advantage or Medicare prescription drug plan, your plan should send you an Annual Notice of Change, commonly called an ANOC, each fall.

Don’t throw it in the pile with the other Medicare mail.

This is one piece you actually want to read.

The Annual Notice of Change explains how your existing plan will change beginning in January.

That can include changes to:

• Premiums
• Deductibles
• Copayments
• Coinsurance
• Prescription coverage
• Other plan benefits

The temptation is to look only at the monthly premium.

I wouldn’t stop there.

A plan with a low premium can still become considerably more expensive if copays, deductibles, prescription costs, or other out-of-pocket expenses change.

The premium is the cover charge. The real question is what the entire year could cost you.

2. Recheck Every Prescription You Take

This may be one of the most important parts of an annual Medicare review.

Prescription drug plans use formularies—lists of medications covered by the plan.

Plans can change how drugs are covered from one year to another.

A medication may:

• Move to a different pricing tier.
• Require different cost sharing.
• Have new coverage restrictions.
• Cost differently depending on which pharmacy you use.

And your own prescriptions may have changed during the year.

That means the plan that was ideal when you selected it last fall may no longer fit your current medication list.

Medicare’s Plan Compare tool allows beneficiaries to enter their prescriptions and preferred pharmacies when comparing plans.

I think that’s much more useful than simply comparing monthly premiums.

A $10 difference in premium may matter a lot less than a significant difference in annual prescription costs.

For 2027, the defined standard Part D benefit also changes. CMS has set the standard deductible at $700 and the annual out-of-pocket threshold for covered Part D drugs at $2,400.

Individual plan designs can differ, so retirees should review the actual terms of the plans available to them rather than relying solely on national figures.

3. Make Sure Your Doctors and Hospitals Are Still in the Network

If you’re enrolled in Medicare Advantage, provider networks can be especially important.

Don’t assume that because your doctor was in-network this year, everything will remain exactly the same next year.

Review:

• Primary care physicians
• Specialists
• Hospitals
• Outpatient facilities
• Preferred pharmacies

This becomes even more important if you see several specialists or receive care through a particular hospital system.

And if you live in more than one state during the year—something many retirees do—pay close attention to how the plan handles non-emergency care outside its local service area.

A Florida winter sounds considerably less relaxing if you discover in January that your healthcare network is 1,000 miles away.

Medicare.gov specifically recommends checking whether the doctors, pharmacies, and benefits you use are included before joining or changing a plan.

4. Don’t Assume a Lower Premium Means Lower Healthcare Costs

CMS currently projects that the weighted average Medicare Advantage monthly premium will fall from $14.37 in 2026 to approximately $12 in 2027.

That sounds encouraging.

CMS also projects the average premium for stand-alone Part D prescription drug coverage to rise by less than $1 per month, from approximately $35.09 in 2026 to $36 in 2027.

But here’s the important part:

Those are national averages.

Your specific plan can look very different.

And even if your premium decreases, another cost could increase.

Think about:

• Specialist copays
• Hospital copays
• Prescription costs
• Deductibles
• Out-of-pocket maximums
• Out-of-network expenses

That’s why I would never evaluate Medicare coverage based only on the premium.

The better comparison is estimated total annual cost combined with the coverage you actually need.

5. Review the Extra Benefits—but Don’t Let Them Drive the Entire Decision

Medicare Advantage plans often advertise additional benefits.

Depending on the plan, those may include things such as:

• Dental
• Vision
• Hearing
• Fitness programs
• Transportation
• Other supplemental benefits

Those benefits can certainly have value.

CMS currently expects hearing, dental, and vision benefit offerings across Medicare Advantage to remain broadly stable in 2027.

But extra benefits shouldn’t distract from the fundamentals.

Before getting excited about a gym membership or dental allowance, I would first ask:

Does the plan cover my physicians?

Does it cover my medications?

What are my major medical costs?

What happens if I need significant care?

How much could I potentially pay out of pocket?

The bells and whistles are nice.

The healthcare coverage is why you’re there.

6. Understand What You’re Giving Up Before Switching Coverage

This becomes particularly important when comparing Medicare Advantage with Original Medicare and supplemental coverage.

Different Medicare arrangements have different tradeoffs involving:

• Provider flexibility
• Networks
• Premiums
• Out-of-pocket costs
• Prescription coverage
• Supplemental coverage

Switching can have consequences.

For example, Medicare cautions that someone who drops a Medigap policy to join Medicare Advantage may not necessarily be able to obtain the same Medigap coverage again later, depending on applicable rules and individual circumstances.

That’s not a reason never to change coverage.

It’s a reason to understand both sides of the decision before making the change.

Healthcare decisions can be difficult to reverse.

That’s very different from changing cable companies because somebody offered you free HBO.

7. Think About Medicare as Part of Your Retirement Budget

This is where I believe financial planning should enter the conversation.

Healthcare isn’t a separate part of retirement.

It’s one of the retirement expenses.

If your healthcare costs change, your retirement cash flow changes.

If your prescription costs increase, that money has to come from somewhere.

Maybe it comes from Social Security.

Maybe an IRA withdrawal.

Maybe a taxable investment account.

Maybe cash reserves.

Those decisions can then interact with your taxes and investment strategy.

That’s why we believe retirees should think beyond simply:

“Which Medicare plan has the lowest premium?”

The better question may be:

“Which coverage fits my healthcare needs and my overall retirement financial plan?”

Those aren’t always the same thing.

What Is Changing for Medicare Advantage and Part D in 2027?

CMS released its initial 2027 Medicare Advantage and prescription-drug outlook on September 28.

Nationally, CMS currently projects:

• The weighted average Medicare Advantage premium to decline from $14.37 to $12 per month.
• More than 99% of Medicare beneficiaries to have access to at least one Medicare Advantage plan.
• Approximately 97% to have access to 10 or more Medicare Advantage options.
• The average stand-alone Part D premium to increase from approximately $35.09 to $36 per month.
• The average prescription-drug component of Medicare Advantage plans to decline from approximately $11.32 to $7 per month.

Those numbers suggest broad choice and relatively stable average premiums.

But averages can be misleading when you’re the person paying the bill.

You don’t enroll in an average plan.

You enroll in one specific plan in one specific area with your specific medications, providers, and healthcare needs.

That’s the number that matters.

Scott’s Perspective

Every year around Medicare Open Enrollment, retirees get buried in mail.

Postcards.

Brochures.

Television commercials.

Phone calls.

Plans promising extra benefits.

After a while, I think many people reach the same conclusion:

“I’ll just keep what I have.”

And sometimes that’s exactly the right answer.

But I’d rather see someone choose to keep their existing plan after reviewing it than keep it simply because changing Medicare coverage feels complicated.

Healthcare is one of the more significant expenses many retirees will face over their lifetime.

Yet people will sometimes spend more time comparing the price of a new television than reviewing the health plan they’ll rely on for the next year.

I think Medicare Open Enrollment is a good annual reminder to ask:

What changed in my plan?

What changed in my health?

What changed with my prescriptions?

What changed with my doctors?

And does my current coverage still make sense?

If the answer is yes, great.

Keep it.

But at least you know why.

Doing nothing after reviewing your options can be a decision. Doing nothing because you never looked is something different.

Why This Matters

Medicare Open Enrollment runs from October 15 through December 7, 2026, with plan changes generally taking effect January 1, 2027.

That gives retirees a relatively short window to review their coverage for the coming year.

The national Medicare outlook for 2027 appears relatively stable.

Your personal situation may not be.

Your prescriptions may have changed.

Your providers may have changed.

Your plan may have changed.

And your retirement budget may have changed.

At Skybox Financial Group, we believe healthcare planning should be considered alongside retirement income, taxes, investments, Social Security, and the other decisions that shape retirement.

Because choosing Medicare coverage isn’t simply about finding an insurance plan.

It’s about understanding how healthcare fits into the retirement you’ve worked decades to build.

Frequently Asked Questions

When is Medicare Open Enrollment for 2027 coverage?

Medicare Open Enrollment begins October 15, 2026, and ends December 7, 2026. Changes made during this period generally take effect January 1, 2027.

Do I have to change my Medicare plan every year?

No. If you’re satisfied with your current coverage and the plan continues to meet your needs, you may keep it. However, Medicare recommends reviewing your coverage each year because costs, benefits, prescriptions, and other plan features can change.

What is an Annual Notice of Change?

The Annual Notice of Change is a document Medicare plans send each fall explaining changes to coverage, costs, and other plan provisions that will take effect the following January.

Are Medicare Advantage premiums going down in 2027?

CMS projects the weighted average Medicare Advantage premium to decline from $14.37 per month in 2026 to approximately $12 in 2027. Individual plan premiums and costs can differ significantly from national averages.

How can I compare Medicare plans for 2027?

Medicare beneficiaries can use the official Medicare Plan Compare tool to review available plans, enter prescriptions and pharmacies, estimate costs, and compare coverage options.

Official Medicare Plan Compare:

Medicare.gov — Compare 2027 Medicare Plans

Is Your Medicare Coverage Still the Right Fit for Your Retirement?

Medicare choices can affect more than healthcare.

They can affect your retirement budget, cash flow, and broader financial plan.

If you’re reviewing your retirement strategy and want to understand how healthcare expenses fit alongside investments, taxes, Social Security, and retirement income, schedule a complimentary 15-Minute Strategic Phone Call with Scott Searles.

Schedule Online

www.talkwithscott.net

Call Our Office

440-238-6983

Sources:

CMS — Medicare Advantage and Medicare Prescription Drug Programs Expected to Remain Stable in 2027

Medicare.gov — Plan Annual Notice of Change

Medicare.gov — Joining a Medicare Plan

Medicare.gov — Compare Medicare Plans

DISCLOSURE

The information provided in this article is for general informational and educational purposes only and should not be construed as personalized investment, tax, or legal advice. Reading this material does not create an advisory relationship with Skybox Financial Group, LLC.

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Before implementing any strategy discussed, you should consult with a qualified financial professional to determine its suitability based on your specific financial circumstances and objectives.