Medicare Enrollment for 2026 Plans: Don’t Miss These Key Details

The Medicare Annual Enrollment Period (AEP) for 2026 plans runs October 15 – December 7, 2025.

Any plan changes you make to your Medicare Advantage or Part D drug plan during this period will take effect on January 1, 2026.

Each year, some rules for the enrollment period carry over while others get updated. For 2026, there are a few important changes just finalized by CMS, along with ongoing requirements you’ll want to keep in mind.

Here’s a clear overview of what’s new — and what still matters — as you review your Medicare plan options for 2026.

What You Can Do During AEP

The Medicare Annual Enrollment Period isn’t a free-for-all for every type of insurance, but it does give you the chance to make important changes — especially to your Medicare Advantage or Part D drug plan.

Medicare Advantage

If you have a Medicare Advantage plan, you can:

• Switch from Original Medicare to a Medicare Advantage plan
• Switch from a Medicare Advantage plan back to Original Medicare
• Switch from a Medicare Advantage plan to a different Medicare Advantage plan
• Switch from a Medicare Advantage plan that doesn’t include prescription drug coverage to one that does, and vice versa

In other words, AEP is your opportunity to review your coverage and make adjustments that fit your health needs and your budget.

Not sure what to do with your Medicare Advantage plan? That’s what we’re here for. Using our contact form, let us know the name of the insurance company and we’ll help you out.

Contact an Agent Today

Medicare Part D (Prescription Drug Plan)

This is the only time of year you can make changes to your Medicare drug plan.

From October 15-December 7, you can:

• Enroll in a stand-alone Medicare Part D Prescription Drug Plan
• Switch from one stand-alone Medicare Part D Prescription Drug Plan to another one
• Drop your prescription drug coverage

Drug plans change every year, and for 2026, there are quite a few updates. That means you could save money by comparing your options.

We encourage you to follow our step-by-step guide (with videos) to check whether your prescriptions are still covered, whether your premium is going up, and whether there’s a better plan out there this year.

Additionally, this year, senior centers in the Decatur area are offering special incentives for the first 100 clients who schedule an appointment to have their Part D plan reviewed. They’re eager to serve as many people as possible, and this is a great way to get a second look at your options while supporting a resource in your community.

Scope of Appointment Waiting Period

Before agents and brokers can talk with you about Medicare Advantage or Part D drug plans, CMS requires that you sign a Scope of Appointment (SOA) form. This form just says you’d like to hear about these types of plans.

In most cases, once the SOA is signed, there’s a required 48-hour waiting period before we can meet with you. This waiting period is meant to give you time to review your options without pressure.

There are a few important exceptions:

• In-person walk-ins: If you stop by our office on your own, we can meet with you right away.
• Inbound calls or requests: If you call us or ask to be contacted, the 48-hour wait doesn’t apply the same way.
• Final four days of enrollment: If we’re within the last four days of an enrollment period, we don’t have to wait the full 48 hours.

We know the rule can feel a little inconvenient, but it’s designed to protect Medicare beneficiaries. And as always, we’re committed to following CMS guidelines while making the process as smooth as possible for you.

Recorded Calls and Disclaimers

We’ll continue to give a disclaimer at the start of certain phone calls and record enrollment conversations per CMS rules.

When this rule first came out, it sounded like all Medicare calls had to be recorded. But CMS later clarified: only enrollment and marketing calls need to be recorded, and those recordings must be kept on file for 10 years.

We record these calls to stay compliant and to protect you.

Protecting Your Personal Data from Third-Party Marketing Organizations

To keep your personal information safe, CMS aims to ensure that any organization handling your Medicare data can't share it with others without your clear, written consent.

This means that if you provide your data through a call or link, it can only be shared with other organizations if you specifically agree to it with written consent.

Each organization that receives your data must get your separate, explicit permission before contacting you for marketing or enrollment.

Rising Medicare Costs in 2026

Premiums and healthcare costs are going up across the board in 2026 — and the increases are larger than what we’ve seen in recent years.

Part B premiums are projected to jump to about $206.50 per month in 2026. That’s nearly double the rate of increase we saw last year. 

Prescription drug plans are also going up. Some plans that used to cost under $50 a month may now be closer to $100 or more.

It’s not just the prices changing — the drug lists are, too. Some companies are cutting back on which medicines they cover, especially the more expensive brand-name drugs. And compared to just a few years ago, there aren’t as many plan options to choose from. Where there used to be 30 or more choices, now there may only be about 15.

What does all this mean for you? It means it’s more important than ever to sit down and review your plan with your Sams/Hockaday agent during this AEP. 

Even if you’re comfortable with your current coverage, a quick check can make sure you’re not paying more than you need to or losing coverage for a medication you rely on.

The Ripple Effects of the Inflation Reduction Act

You might have heard about the Inflation Reduction Act. One of its biggest changes was capping 2025 annual out-of-pocket prescription costs at $2,000, instead of the $4,000+. That cap will rise slightly to $2,100 in 2026.

That’s good news if you take expensive medicines — once you hit that cap, you won’t have to keep paying more.

But there’s another side to it. Since only a small number of people used to hit the old $4,000 limit, insurance companies are now spreading those costs across everyone. 

So while this new protection helps those with very high drug costs, it also means many people will see higher monthly premiums.

Medicare Advantage: Something to Think About

Because drug plans are getting more expensive and there are fewer of them to pick from, more people are starting to look at Medicare Advantage plans. These plans roll your medical and drug coverage into one, which can sometimes save money.

But keep in mind that Medicare Advantage is changing, too. 

In many areas, there are fewer PPO options and more HMO plans. That means your network of doctors may be more limited. Also, the list of covered drugs for Medicare Advantage doesn’t come out until October 1, which only gives us a short time to review it before the enrollment period begins.

Mid-Year Notification of Unused Supplemental Benefits

To help Medicare Advantage members actually use the extra perks in their plans, CMS now requires insurers to send a personalized “Mid-Year Enrollee Notification” between June 30 and July 31 each year.

This notice will spell out which supplemental benefits you haven’t used in the first half of the year, explain what those benefits cover, outline any costs, and tell you exactly how to use them (with phone numbers or links for support).

Since this rule is new, you may notice this letter for the first time in 2026. Be sure to read it — you might find valuable benefits you didn’t even know were available to you.

Annual Notice of Change

If you’re enrolled in a Medicare Advantage or Medicare Part D plan, you’ll receive an Annual Notice of Change (ANOC) in September. This letter outlines what’s changing in your plan for the upcoming year — things like premiums, copays, drug coverage, and even whether your doctors and hospitals are still in the network.

This year, it’s more important than ever to read your ANOC carefully. With rising costs, some plans are becoming too expensive for insurance companies to keep, and a number of plans are being discontinued for 2026. In fact, over a million people nationwide may find that their current Medicare Advantage plan will no longer be offered. 

If you have a Medicare Advantage plan, keep a close eye on your ANOC. 

If your plan is leaving the market and you don’t pick a new one, you risk starting 2026 without coverage. Even if your plan continues, changes in costs or benefits could mean it’s no longer the right fit for you.

That’s where we can help. Your Sams/Hockaday agent will walk you through your ANOC, explain what’s changing, and compare your options side by side.

Creating a Medicare Account

If you haven't already signed up for a Medicare.gov account, please do so! It will make your life a lot easier when trying to select which drug plan is best for the upcoming year.

All medications you've filled throughout the year will show up on your account, allowing you to quickly choose which drug plan matches your prescription list.

Having a Medicare login is also very beneficial for us when it's time to serve you.

Phone Appointments Are Available

We are able to assist clients over the phone if desired! Oftentimes, a quick phone call is all we need to make sure you're on the right plan for 2026.

Communicate with your current agent to determine if a phone or in-office appointment is preferred.

Watch Out for AEP Ads

Private Medicare Advantage (MA) plans and big call centers advertise a lot during AEP.

Also be prepared for a lot of commercials advertising free dental and vision benefits and mentioning things like Part B givebacks, free flex cards, and more.

While some of these extra perks are nice, availability differs, and we recommend choosing a plan for its health coverage, not the perks.

We can help you compare the available plans in Macon County and surrounding areas.

Read More: 6 Simple Ways to Tell If Medicare Advantage Is Right For You

Make the Most of Medicare's Enrollment Season

In order to make the most of the 2025 enrollment season for 2026 plans, your goal is to have great coverage for a great price. We come across a lot of individuals who believe getting the lowest premium is the goal, but it really isn't!

Your goal is to minimize your total out-of-pocket costs for the year. Premiums are only one part of the equation when it comes to all of your healthcare expenses.

You also have deductibles, coinsurance, and copays. Don’t make the mistake of choosing a plan for its low monthly premium only to find out later that your deductible is very high.

This can often happen with both Medicare Advantage plans and Part D drug plans, so be sure you understand all your costs before making any changes.

You also want to know what the network is like – Medicare Advantage plans often have limited networks, which means you’re only allowed to see certain doctors. That might end up being important to you!

Changing Plans Later On

What happens if you totally miss the Medicare annual enrollment season?

If you don’t take action from October 15-December 7, your options for changing Part D drug plans are limited. You’d have to qualify for a special enrollment period, which includes situations like getting kicked off of your employer’s group plan or your plan getting terminated.

If you don’t qualify for a special enrollment period, you have to wait until October 15, 2026, to make changes.

For Medicare Advantage, the only change you can make after December 7, 2025, is to drop your plan and switch to Original Medicare. You can do that during the Medicare Advantage Open Enrollment Period (OEP), which is from January 1-March 31.

Conclusion

You don’t actually need to know every detail about the enrollment process – that’s what we’re here for.

Simply contact us, and our licensed agents will help you save money on your own health plan for next year.

Also, don’t forget to download your Enrollment Period To-Do List. This will help you save money before the 2025 Enrollment Period for 2026 plans is over and it’s too late!