Medicare Enrollment Windows: 2026
| Enrollment Period | Dates | Who It Applies To | What You Can Do |
|---|---|---|---|
| Annual Enrollment Period (AEP) | Oct 15 – Dec 7, 2025 | Anyone with Medicare | Switch MA plans; join/change Part D; switch between Original Medicare and MA |
| MA Open Enrollment (MA OEP) | Jan 1 – Mar 31, 2026 | Current MA enrollees only | Switch MA plans once; switch back to Original Medicare + Part D |
| Initial Enrollment Period | 7 months around your 65th birthday | New to Medicare at 65 | Enroll in Parts A, B, C, D; sign up for Medigap |
| Special Enrollment Periods | Year-round (qualifying events) | Qualifying event (losing coverage, moving) | Make specific changes based on the qualifying event |
| Medigap OEP | 6 months from Part B start at 65 | New Part B enrollees | Enroll in any Medigap plan without underwriting |
Key 2026 Medicare Changes
Part D — $2,000 Out-of-Pocket Cap (Major Change)
The most significant 2026 Medicare change is the $2,000 annual out-of-pocket cap for Part D prescription drugs, enacted under the Inflation Reduction Act. This eliminates the catastrophic coverage phase that previously required beneficiaries to pay 5% of drug costs indefinitely after reaching a threshold. Once you've spent $2,000 out of pocket on covered drugs in 2026, your Part D plan pays 100% for the rest of the year.
Additionally, the Inflation Reduction Act's Medicare Prescription Payment Plan allows you to spread out-of-pocket drug costs across monthly installments rather than paying large amounts at the pharmacy counter at the beginning of the year.
2026 Medicare Cost-Sharing at a Glance
| Benefit | 2026 Amount |
|---|---|
| Part A deductible (per benefit period) | $1,676 |
| Part A coinsurance (days 61–90) | $419/day |
| Part A coinsurance (lifetime reserve days 91–150) | $838/day |
| Skilled nursing facility coinsurance (days 21–100) | $209.50/day |
| Part B standard premium | $185/month |
| Part B deductible | $257 |
| Part B coinsurance (after deductible) | 20% of Medicare-approved amount |
| Part D out-of-pocket cap | $2,000 |
| High-Deductible Plan G deductible | $2,870 |
| Plan K out-of-pocket limit | $7,220 |
| Plan L out-of-pocket limit | $3,610 |
Annual Review Checklist
Every year during the Annual Enrollment Period (October 15 – December 7), review these factors to make sure you have the right coverage for the coming year:
If You Have Medicare Advantage
- Review your Annual Notice of Change (ANOC). Your insurer must send this by September 30 each year. It lists all changes to your plan for the coming year — premiums, copays, drug formulary changes, and network changes.
- Check if your doctors are still in-network. Provider networks change annually. If your primary care doctor or a specialist you rely on has left the network, you'll pay more or may need to switch plans.
- Verify your prescriptions are still covered. Formularies change. Use the plan's drug cost estimator or Medicare.gov to check your specific medications on any plan you're considering.
- Compare total cost, not just premium. A $0-premium plan with higher copays can cost more than a plan with a monthly premium if you use a lot of healthcare.
If You Have Original Medicare + Medigap
- Review your Medigap premium notice. If your insurer has raised rates significantly, compare quotes from competitors. In most states you'll face underwriting to switch, but states with Birthday Rules (CA, FL, OR) allow annual switches.
- Review your Part D plan. Your Part D plan can change its formulary, premiums, and pharmacy network each year. Use Medicare.gov's Plan Finder to find the lowest-cost plan for your specific medications.
- Consider if you still need the same Medigap plan. If your health has changed significantly, you may want more or less coverage — but be aware of underwriting requirements before making changes.
For Everyone: Check Extra Help Eligibility
Medicare's Extra Help (Low Income Subsidy) program helps pay Part D costs for people with limited income and resources. Eligibility thresholds for 2026 are approximately:
- Individual income up to ~$22,590/year (150% of FPL)
- Couple income up to ~$30,660/year
- Asset limits also apply (check SSA.gov for current thresholds)
If you qualify, Extra Help can save you thousands of dollars annually on prescription drug costs. Apply through the Social Security Administration at ssa.gov/extrahelp.
How to Compare Medicare Plans
The official tool for comparing Medicare plans is Medicare.gov's Plan Finder. Enter your medications, preferred pharmacies, and location to see cost estimates for Medicare Advantage and Part D plans in your area.
For Medigap (Medicare Supplement) plan comparisons and quotes, use the Plan Finder or contact a licensed insurance broker who represents multiple companies. Because Medigap benefits are federally standardized, the only variable is the premium — so comparing quotes from multiple insurers is always worthwhile.
Frequently Asked Questions
When is Medicare Open Enrollment 2026?
Medicare's Annual Enrollment Period (AEP) for 2026 coverage runs from October 15 to December 7, 2025. Changes take effect January 1, 2026. During this window, you can switch Medicare Advantage plans, switch from Original Medicare to Medicare Advantage or vice versa, join or change your Part D drug plan, or drop Part D if you have other creditable coverage.
What is the Medicare Advantage Open Enrollment Period?
The Medicare Advantage Open Enrollment Period (MA OEP) runs January 1 to March 31 each year. If you are already enrolled in a Medicare Advantage plan, you can switch to a different MA plan or switch back to Original Medicare (and enroll in a Part D plan). You cannot use the MA OEP to switch from Original Medicare to Medicare Advantage.
Can I change my Medigap plan during open enrollment?
Medigap (Medicare Supplement) plans work differently from Medicare Advantage. There is no annual open enrollment for Medigap in most states. To switch Medigap plans, you typically need to pass medical underwriting in most states. Exceptions: California, Florida, and Oregon have Birthday Rules allowing annual switches without underwriting. New York and New Jersey have year-round guaranteed issue.
What changes for Medicare in 2026?
Key 2026 Medicare changes: (1) The Part D out-of-pocket cap is $2,000 (introduced under the Inflation Reduction Act — a significant reduction from prior years). (2) Part B premium is $185/month (standard). (3) Part A deductible is $1,676 per benefit period. (4) Part B deductible is $257. (5) Part D Extra Help income and asset limits updated for 2026.
What happens if I miss Medicare open enrollment?
If you miss the Annual Enrollment Period (October 15–December 7), your next opportunity to make most changes is the following year's AEP. However, the Medicare Advantage Open Enrollment Period (January 1–March 31) allows Advantage enrollees to make one plan change. Special Enrollment Periods may be available for certain qualifying events like moving or losing other coverage.
This site provides general information about Medicare Supplement insurance and medical alert devices. It is not affiliated with or endorsed by the Centers for Medicare & Medicaid Services (CMS) or any government agency. This is not medical or insurance advice. Always consult a licensed insurance professional for personalized guidance.
Medicare rules, premiums, and plan availability change annually. Always verify current information with Medicare.gov, your State Insurance Department, or a licensed insurance advisor. For free, unbiased help, contact your State Health Insurance Assistance Program (SHIP) at shiphelp.org.
Sources
- Medicare.gov. Medicare Open Enrollment. medicare.gov. Retrieved June 2026.
- CMS. 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved June 2026.
- CMS. Medicare Prescription Payment Plan. cms.gov. Retrieved June 2026.