Q: What do I need to know about Medicare Open Enrollment this year?
A: Medicare Open Enrollment is a set time each year when anyone who has Medicare health insurance can change their health plan and their prescription drug plan. Open Enrollment starts on October 15th and ends on December 7th. Any changes you make will take effect on January 1, 2026. Not only is this a time when people with Medicare can change their plan, but is also the time when plans announce their changes for the following year.
Even if you are currently happy with your current Medicare plan, it is important to review the changes to ensure the plan will continue to meet your needs.
The Health Insurance Counseling and Advocacy Program (HICAP), part of the Ventura County Area Agency on Aging (VCAAA), provides free, unbiased counseling on all parts of Medicare. During Open Enrollment, HICAP offers One-Stop Shops where you can schedule an appointment to review your plan, as well as attend community education presentations. You can learn more at https://vcaaa.venturacounty.gov/our-services/medicare-help/ or by calling HICAP at 805-477-7300.
Appointments are required to meet with a HICAP counselor. You will be instructed to first complete a Comparison Form with your personal information and a list of your medications.
When you meet with a HICAP counselor, they will help you understand any changes to Medicare plans and provide you with trusted and unbiased education. They will run a plan comparison for you based on your specific information and prescription list, to help you make an informed choice for next year.
A few of the changes coming to Medicare in 2026 include an increase in the Part A deductible, going from $1,676 to $1,716 per hospital stay of care. The premium for Medicare Part B is also increasing from $185 a month to $206.50 per month. Medicare’s Part D average monthly premium for prescription coverage is expected to increase from $35 to $50 a month. The annual prescription cap for medications is $2,100.
HICAP can also assess you for the Medicare Savings Program, which can helps individuals with limited income and assets pay for their Medicare premiums, deductibles, coinsurance, and copayments.
It is also important to be cautious when sharing your Medicare information and not to enroll in anything that sounds too good to be true. HICAP is also the local Senior Medicare Patrol entity, and they can help report any fraud and abuse relating to Medicare.
Every person has unique medical and prescription needs related to their health insurance. I often hear people sign up for plans because their friend tells them it is the best. The truth is, that plan may be the best for your friends’ needs. But that does not guarantee it will be for you.
Take the time during Open Enrollment this year and every year to make informed decisions for your healthcare needs. Taking some time now could make a significant difference for your coverage in 2026.
Martha Shapiro can be reached at Senior Concerns at 805-497-0189 or by email at mshapiro@seniorconcerns.org.
