Medicare Open Enrollment Checklist
Review doctors, drugs, pharmacies, premiums, prior authorization, travel, and total risk before keeping or switching a plan.
The plan that worked last year should earn its place again with current doctors, drugs, pharmacies, and total cost exposure.
Medicare open enrollment is not just a shopping season. It is a yearly safety check for coverage that can change.
Quick answer
The plan that worked last year should earn its place again with current doctors, drugs, pharmacies, and total cost exposure.
Applies To 2026
Applies to 2026 Medicare costs and rules. Review annually before Medicare Open Enrollment and again after CMS, Medicare.gov, and Social Security publish new annual cost updates.
Plain-English Summary
Medicare Open Enrollment is the yearly time to review coverage and make changes.
Medicare Open Enrollment generally runs from October 15 through December 7, with changes effective January 1 if the plan receives the request by December 7.
Open Enrollment is not just for switching plans. It is for checking whether the current plan still works.
A plan can change. A person's health can change. Prescriptions can change. Doctors can leave networks. Pharmacies can change pricing. Benefits can shift.
What To Review
1. Current Coverage
Write down:
- Original Medicare or Medicare Advantage.
- Part D plan.
- Medigap policy if applicable.
- Premiums.
- Deductibles.
- Copays.
- Coinsurance.
- Out-of-pocket maximum.
- Drug costs.
2. Doctors And Hospitals
Check:
- Primary doctor.
- Specialists.
- Preferred hospitals.
- Therapy providers.
- Home health providers.
- Pharmacies.
- Durable medical equipment suppliers.
3. Prescriptions
Check:
- Exact drug names.
- Dosages.
- Frequency.
- Drug tiers.
- Prior authorization.
- Step therapy.
- Quantity limits.
- Preferred pharmacy pricing.
4. Expected Care Next Year
Ask:
- Is surgery expected?
- Are specialist visits increasing?
- Are new medications likely?
- Is therapy needed?
- Is home health possible?
- Is a move possible?
- Is long-term care being considered?
5. Cost Exposure
Compare:
- Monthly premiums.
- Annual deductibles.
- Drug costs.
- Copays.
- Coinsurance.
- Out-of-pocket maximum.
- Non-covered services.
- Travel-related risk.
Kefiw Tip: Review The Annual Notice Of Change First
Do not shop blindly. First ask:
"What changed in my current plan?"
Then decide whether the change matters. A small premium change may be less important than a drug tier change, provider network change, pharmacy change, or new prior authorization rule.
A Calmer Fall Timeline
- September: collect plan notices and update medication list.
- October: compare options.
- November: verify doctors, drugs, pharmacies, and expected costs.
- By December 7: submit any change if switching plans.
Waiting until the last week creates pressure and makes it easier to accept a sales pitch without checking the facts.
Questions To Ask
- What changed in the current plan?
- Are doctors still in network?
- Are drugs still covered?
- Did pharmacy pricing change?
- Did the premium change?
- Did the deductible change?
- Did copays change?
- Did prior authorization rules change?
- Is the out-of-pocket maximum different?
- Would SHIP counseling help?
Family Script
"Before we keep this plan by default, let us check whether anything changed: doctors, drugs, pharmacy, prior authorization, premiums, and the bad-year cost."
Red Flags
- Staying in a plan because it worked last year.
- Comparing premiums only.
- Not checking prescriptions.
- Not checking providers.
- Waiting until the last week.
- Relying only on advertisements.
- Assuming extra benefits matter more than core medical access.
- Ignoring travel or moving plans.
Checklist
- Review Annual Notice of Change.
- Update medication list.
- Check doctors.
- Check hospitals.
- Check pharmacies.
- Compare premiums.
- Compare deductibles.
- Compare drug costs.
- Compare out-of-pocket maximums.
- Check prior authorization.
- Ask SHIP or a qualified professional for help if needed.
- Submit changes by December 7 if changing plans.
Related Kefiw Tools
Before Choosing Coverage
Check the practical details before comparing plan marketing:
- Doctors.
- Hospitals.
- Prescriptions.
- Pharmacy.
- Premiums.
- Deductibles.
- Copays.
- Coinsurance.
- Out-of-pocket maximum.
- IRMAA.
- Travel.
- Long-term care assumptions.
Ask For Unbiased Help
For free personalized Medicare counseling, contact a local State Health Insurance Assistance Program, or SHIP. SHIPs are not connected to insurance companies or health plans.
Calculator Connection
Not sure what this means for the budget? Use the Medicare Cost Calculator, Medicare IRMAA Calculator, Part B Premium Calculator, or Part D Estimate to turn coverage details into a clearer monthly and yearly cost picture.
Professional Review
Recommended reviewer: Medicare specialist or licensed insurance professional
Sources To Verify
- Medicare.gov: Compare Original Medicare and Medicare Advantage
- Medicare.gov: Part D drug coverage costs
- SHIP: Free Medicare counseling
Last reviewed: April 29, 2026.
Kefiw Medicare Disclaimer
Kefiw provides educational care-planning tools and guides. Medicare costs, coverage rules, plan networks, drug formularies, premiums, penalties, enrollment windows, and eligibility rules can change and may vary by person, plan, location, income, and timing. This content does not replace guidance from Medicare, Social Security, SHIP, a licensed insurance professional, tax professional, legal professional, or medical professional.
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Frequently asked questions
› Who should use this medicare open enrollment checklist? How-to
Use it when the family needs a practical conversation starter, a checklist for provider calls, or a way to connect care concerns to costs and next steps.
› Can this guide replace professional advice? Trust & accuracy
No. It is designed to organize questions and decisions before speaking with clinicians, Medicare resources, insurers, elder law attorneys, care providers, or other qualified professionals.
› What should families do first? How-to
Write down the immediate safety concern, the care tasks that are already happening, the expected monthly cost, and the person responsible for the next call.
› How should I use this guide with a Kefiw tool? How-to
Use the guide as the plan and the linked Kefiw tool as the check. Read the steps first, try the move manually, then use the tool to compare outputs, catch edge cases, and decide whether the result actually fits your task.
› What mistake do tool guides help avoid? Troubleshooting
Tool guides help avoid using a utility mechanically without understanding what you are trying to accomplish. Most word, writing, and text utilities are fast, but speed can hide context mistakes. Know whether you are solving a puzzle, cleaning copy, drafting a line, or checking a rule.