Medicare Open Enrollment: What to Check Before December 7

You have until December 7, 2026 to change your Medicare health or drug plan, and the new plan starts January 1, 2027. If you do nothing, your current plan renews, and every premium, drug list and network change it announced for 2027 starts on January 1. Today, find your plan's Annual Notice of Change, list every drug you take and every doctor you see, and price them on Medicare Plan Finder.

In California, CMS reports that everyone in a stand-alone drug plan can pick a 2027 plan with a lower premium than they paid in 2026.

The dates that decide your 2027 coverage

• October 15 to December 7, 2026: join, switch or drop a Medicare Advantage plan or a stand-alone drug plan, or move between Original Medicare and Medicare Advantage. The plan must receive your request by December 7.
• January 1 to March 31, 2027: Medicare Advantage members get one more change, to another Medicare Advantage plan or to Original Medicare plus a stand-alone drug plan, starting the first of the month after the plan gets the request. People in Original Medicare cannot switch drug plans in this window, so December 7 is their deadline.
• December 8, 2026 to November 30, 2027: you can switch once into a plan with a 5-star quality rating, if one is offered where you live.

If you enroll in two plans before December 7, the request you made last is the one Medicare keeps.

What to check in your Annual Notice of Change

Your plan sends the Annual Notice of Change by September 30 and the Evidence of Coverage, which details what the plan covers and what you pay in 2027, by October 15. If either is missing, call your plan and ask for it.

The yearly cap on Part D drug costs rises to $2,400 in 2027, from $2,100. Once you, or a program paying on your behalf such as Extra Help, have spent $2,400 on covered drugs, you pay $0 for covered Part D drugs for the rest of the year. Each covered insulin still costs no more than $35 for a month's supply, with no deductible.

What to do today

1. Pull out the notice. Circle the 2027 premium, the deductible and any drug that moved to a higher tier or came off the list.
2. Make your list. Write each drug with its strength and how often you take it, your pharmacy, and every doctor, specialist and hospital you saw this year.
3. Price it on Plan Finder. At Medicare.gov/plan-compare, enter your ZIP code, your drugs, your pharmacy and your doctors. Plan Finder estimates each plan's yearly drug and premium cost, shows which of your doctors are in network, shows star ratings, and flags 2027 changes to your current plan.
4. Call before you pick a Medicare Advantage plan. Ask each doctor's office whether they will be in network with that exact plan on January 1, 2027, and ask the plan about prior authorization for the care you use most. The script below covers both calls.
5. Enroll. Select Enroll on Plan Finder, call the plan, or call 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048), which answers 24 hours a day. Note the date and any confirmation number. Your old Medicare Advantage or drug plan ends by itself when the new one starts. If you move to Medicare Advantage, most Medigap policies stay in force until you cancel them with the insurer.
6. Get a free second look. Your State Health Insurance Assistance Program (SHIP) gives free one-on-one counseling and has no tie to any insurer; find yours at shiphelp.org. In California, the SHIP is HICAP: call 1-800-434-0222 for your county's office, which also gives legal help or referrals on Medicare problems.

Where it splits

• If you are moving from Medicare Advantage to Original Medicare: join a stand-alone drug plan by December 7. That ends your Medicare Advantage plan automatically, with no gap in coverage. If you want Medigap too, apply before you switch and ask for a January 1 start date. Without a guaranteed issue right or a broader state rule, a Medigap insurer can turn you down or charge more because of your health. You have that right in your first year of Medicare Advantage if you joined when first eligible at 65, or dropped a Medigap policy to try Medicare Advantage for the first time. If an insurer turns you down, rejoin a Medicare Advantage plan by December 7, and that later request stands.
• If your plan sent a letter saying it is leaving Medicare or your area: pick a new plan by December 7 so it starts January 1. A special enrollment period gives you until the last day of February 2027, and if you join no new plan, you go to Original Medicare with no drug plan, so join a stand-alone drug plan in the same window (by December 7 for a January 1 start). Insurers must then sell you Medigap Plan A, B, D or G (A, B, C or F if you were eligible for Medicare before 2020) if you apply within 63 days after the plan ends. The same Medigap right applies when your plan's network has a significant change and you move to Original Medicare.
• If you get Extra Help or have Medicaid: you can switch to another stand-alone drug plan, or move from Medicare Advantage to Original Medicare with a drug plan, once a month all year, starting the first of the next month. The exception is a member whose plan has sent a letter naming them at risk under its drug management program. Copays in 2027 are no more than $5.80 for a generic and $14.40 for a brand-name drug at a network pharmacy.
• If you have retiree coverage from a former employer or union: call that benefits office before you join any Medicare plan. Signing up for other coverage can end the employer or union health and drug coverage for you and your dependents, and you may be unable to get it back.

What protects you after you switch

• A transition fill, then an exception. In your first 90 days with a new drug plan, the plan must give you a one-time supply of at least a month of a drug that is off its list or needs prior authorization or step therapy. Use that month to have your prescriber ask for an exception, with a statement of the medical reason; ask for a fast decision if waiting could harm your health.
• Treatment already underway. If you join a new Medicare Advantage plan in the middle of a course of treatment, the plan must give you at least 90 days without new prior authorization, even when the provider is out of network.
• Prior authorization deadlines. Medicare Advantage plans must answer a standard prior authorization request within 7 calendar days and a fast one within 72 hours, with up to 14 extra days allowed in limited cases. A denial comes in writing, and you can appeal it.
• Spreading drug costs. The Medicare Prescription Payment Plan turns pharmacy costs into monthly bills from January to December. Joining a new plan ends your participation, so sign up again with the new plan.
• Extra Help. In 2026 you qualify with yearly income under $23,940 for a single person or $32,460 for a married couple living together, and resources under $18,090 or $36,100, not counting your home, car or burial plot. The income limit is higher if you have earnings from work, have dependents living with you, or live in Alaska or Hawaii. Apply any time at SSA.gov/extrahelp, or call Social Security at 1-800-772-1213 for an appointment. People with full Medicaid, a Medicare Savings Program or SSI get Extra Help automatically; Californians can check the Medicare Savings Programs and Medi-Cal income limits.

What to say when you call

To a doctor's office: "Hi, my name is [name], date of birth [date], and I'm a patient of Dr. [name]. Will Dr. [name] and [clinic or hospital] be in network with [exact plan name from Plan Finder] on January 1, 2027?"

To the plan: "I'm comparing [exact plan name] for 2027. Is [drug name and strength] on your 2027 drug list, on which tier, and with any prior authorization, step therapy or quantity limit? What will a 30-day supply cost at [pharmacy name]? Does [service you use, such as physical therapy or an MRI] need prior authorization, and do I need a referral to see [type of specialist]?"

Today

1. Find your Annual Notice of Change and circle the 2027 premium, the deductible and every drug change.
2. Enter your drugs, pharmacy and doctors on Medicare Plan Finder and compare the yearly cost estimates.
3. If another plan comes out ahead, enroll by December 7, or call your SHIP (HICAP in California, 1-800-434-0222) first.

After you enroll, the new plan sends a letter with your start date. If the change is missing from your Medicare account 10 days after you made it, call the new plan. From January 1, use the new plan's member card at the doctor and the pharmacy.