What it is, what you can change, and why right now is the time to act
Every fall, millions of Americans with Medicare get a chance to review their coverage and make changes. It’s called Medicare Open Enrollment, and it runs from October 15 through December 7. If that sounds overwhelming, you’re not alone. Medicare can feel like a maze of parts and plans and deadlines. But you don’t have to figure it all out by yourself.
At Northeast Independent Living Services (NEILS), we help people with disabilities and older adults in Northeast Missouri navigate exactly these kinds of decisions. Let’s break it all down in plain language.
What Is Medicare Open Enrollment?
Medicare Open Enrollment is a window of time each year when you can review your current Medicare coverage and make changes. This year, that window is October 15 through December 7, 2026. Any changes you make during this period will take effect on January 1, 2027.
If you don’t make any changes, that’s okay. Your current plan will simply continue into the new year. But it’s still worth taking a look, because plans change from year to year, and what worked well last year might not be your best option anymore.
The Parts of Medicare
Medicare has four main parts. Here’s a simple breakdown:
Part A — covers hospital stays, skilled nursing care, and some home health services. Most people don’t pay a monthly premium for Part A.
Part B — covers doctor visits, outpatient care, and preventive services. Most people pay a monthly premium for Part B, which is around $185 per month in 2026.
Part C — also called Medicare Advantage, Part C is a bundled plan offered through private insurance companies. These plans combine Parts A and B and often include extra benefits like dental, vision, or prescription coverage.
Part D — covers prescription drugs. You can add a Part D plan to Original Medicare (Parts A and B), or you may get drug coverage through a Medicare Advantage plan.
What Can You Actually Change During Open Enrollment?
During the October 15 through December 7 window, you can:
- Switch from Original Medicare (Parts A and B) to a Medicare Advantage plan
- Switch from Medicare Advantage back to Original Medicare
- Switch from one Medicare Advantage plan to a different one
- Join a Part D prescription drug plan for the first time
- Switch from one Part D plan to another
- Drop your Part D plan entirely
You cannot use this window to enroll in Medicare for the very first time. That happens when you first become eligible at age 65.
Should You Make a Change This Year?
That depends on your situation. Here are some good questions to ask yourself:
Did your plan send you a notice? Each fall, Medicare plans are required to send their members an Annual Notice of Change (ANOC) by September 30. This letter explains what is changing in your plan for next year, including changes to premiums, copays, or covered services. If you haven’t looked at yours, now is the time.
Are your prescriptions still covered? Drug formularies, the fancy official name for the list of medications a plan covers, can change from year to year. Check to make sure your prescriptions will still be covered at a reasonable cost.
Are your doctors still in-network? If you have a Type C Medicare Advantage plan, your network of in-network providers can also change. Make sure the doctors and specialists you see are still included.
Is there a better plan available? You can compare plans in your area at medicare.gov. It’s free to use and lets you search by your zip code, your medications, and your doctors.
If You Miss the Deadline
Life gets busy. If December 7 comes and goes and you didn’t make changes, there’s still a limited opportunity.
The Medicare Advantage Open Enrollment Period runs from January 1 through March 31, 2027. During that window, you can switch between Medicare Advantage plans or drop a Medicare Advantage plan and go back to Original Medicare. It’s not as flexible as the fall enrollment period, but it’s a helpful safety net just in case you need it.
NEILS Can Help You Navigate Your Benefits
Medicare is just one piece of the puzzle when it comes to living independently. NEILS offers a range of services to help people with disabilities and older adults in Northeast Missouri get the support they need at home.
Our Home Care Services can help with daily tasks like personal care, meal preparation, and medication reminders, so you can stay safely in your home while you focus on managing your health and coverage.
Through Consumer-Directed Services, you can hire a trusted family member or friend as your paid caregiver, with NEILS handling all the payroll and oversight.
Medicare decisions can be complicated. But you don’t have to make them alone.
Talk to Someone Who Can Help
If you have questions about your Medicare coverage or your options during open enrollment, reach out to your local State Health Insurance Assistance Program (SHIP) counselor. In Missouri, SHIP counselors offer free, unbiased help to Medicare beneficiaries.
And if you need help with home-based support services, NEILS is here for you. Call us today at 573-221-8282 or visit our Contact Us page to learn how we can support your independence this year and beyond.