Medicare open enrollment runs from October 15 to December 7, 2026. It is the one time each year when anyone with Medicare can change how they get coverage. Any changes you make start on January 1, 2027.
If you are a retired teacher or public worker, open enrollment comes with one extra warning: your retiree health plan. We cover that below.
What you can change
During open enrollment you can:
- Switch from Original Medicare to a Medicare Advantage plan
- Switch from a Medicare Advantage plan back to Original Medicare
- Move from one Medicare Advantage plan to another
- Join, switch or drop a Part D drug plan
If you are happy with your plan and nothing changed, you do not have to do anything. Your plan will usually renew on its own.
Original Medicare vs Medicare Advantage
| Original Medicare | Medicare Advantage | |
|---|---|---|
| Who runs it | The federal government | Private insurance companies approved by Medicare |
| Doctors | Any doctor who takes Medicare | Usually a network of doctors |
| Drug coverage | Add a Part D plan | Often included |
| Extra costs | Many people add a Medigap plan | Set copays, with a yearly cap on costs |
| Extras | Few | Some include dental, vision or hearing |
There is no single right answer. Original Medicare gives more freedom to choose doctors. Medicare Advantage can cost less each month but limits you to a network.
Why you should check your plan this year
Plans change every year. Your plan’s monthly cost, copays, drug list and doctors can all change on January 1. In the fall, your plan sends a notice called the “Annual Notice of Change.” It lists what is different for 2027. Read it.
There is good news on drug costs. Since 2025, people with Part D coverage have a yearly cap on what they pay out of pocket for covered drugs. In 2026 the cap is $2,100.
A 15-minute checklist
- Find your Annual Notice of Change and look at what is changing.
- List your drugs and doctors.
- Use the Plan Finder at Medicare.gov to compare plans in your area. Enter your drugs to see real costs.
- Check your pharmacy. Some plans charge much less at “preferred” pharmacies.
- Call your retiree health plan before you switch. More on that next.
The big warning for retired public workers
Many teacher and public pension systems offer retiree health coverage. Texas has TRS-Care. California has CalPERS Medicare plans. Many school districts and states have their own.
These plans often work with Medicare in a special way. If you switch to a different Medicare plan on your own, you might lose your retiree coverage, and you may not be able to get it back. That can include coverage for your spouse.
Before you change anything, call your pension system or retiree health office and ask: “If I change my Medicare plan, what happens to my retiree coverage?”
Do you have Medicare if you never paid Social Security?
Most likely yes. Public workers hired after March 31, 1986 pay the Medicare tax even when their job does not pay into Social Security. Ten years of that work gives you Medicare Part A with no monthly premium. If you do not have enough, you may get free Part A through your spouse’s work record.
Part B, which covers doctor visits, has a monthly premium for almost everyone. Sign up when you turn 65 unless you have coverage from a current job, or you may pay a penalty of 10% for each year you waited, for life.
If you miss December 7
If you are in a Medicare Advantage plan, you have one more chance. From January 1 to March 31, you can switch to a different Medicare Advantage plan or go back to Original Medicare. If you go back to Original Medicare, keep in mind that in most states, a Medigap plan can turn you down or charge more after your first six months on Part B.
Get free help
Every state has a free Medicare counseling program called SHIP. Counselors do not sell insurance. They help you compare plans for free. You can find yours through Medicare.gov or by calling 1-800-MEDICARE.
Questions people ask
Do I have to re-enroll every year? No. If you do nothing, your plan usually continues.
Can I change plans any time? Not usually. Outside open enrollment you need a special reason, such as moving.
Does Medicare cover my spouse? Each person has their own Medicare. Your spouse enrolls separately when they turn 65.
Read our full guide to retiree health insurance, including how to cover the years before 65.