What to check before you lock in a 2026 Medicare plan

Every autumn, millions of older Americans receive a thick envelope from their Medicare plan and set it aside. That is understandable — the language is dense and the changes are easy to miss. But the notice, formally called the Annual Notice of Change, is the single most important document you will read about your coverage all year. It spells out exactly how your plan will differ in the year ahead.

The review does not need to take long. Working through a handful of specific questions is usually enough to tell whether your current plan still fits, or whether it is worth comparing alternatives during the open enrollment window.

Start with the four numbers that change most

Plans adjust their costs and rules on a yearly cycle. Before comparing anything, write down where your current plan stands on each of the following.

• The monthly premium, and whether it rose or fell from this year.
• The annual deductible for medical care and, separately, for prescription drugs.
• The out-of-pocket maximum — the ceiling on what you can be asked to pay in a year.
• The drug formulary tier for each medication you take regularly.

A plan can keep its premium flat while quietly moving one of your prescriptions to a higher cost tier. That is why the formulary deserves a line-by-line look rather than a glance at the headline price.

Confirm your doctors and pharmacy are still in network

Networks are renegotiated every year. A physician or pharmacy that was covered this year may sit outside the network next year, which can turn a routine visit into a full-price bill. Check each provider you rely on, and do it before you renew rather than after.

The plan that was right for you two years ago may no longer be the plan that is right for you today. Nothing about your coverage is automatic once your health or your prescriptions change.

A common refrain among independent benefits counselors

Where to get unbiased help

Free, one-on-one counseling is available through the State Health Insurance Assistance Program, known as SHIP, in every state. Counselors do not sell plans and are not paid on commission, which makes them a useful counterweight to marketing calls and mailers.

If you prefer to compare on your own, the official Medicare Plan Finder lets you enter your prescriptions and preferred pharmacy to see estimated yearly costs across plans. Whichever route you choose, give yourself time before the December deadline so a rushed decision does not carry into the new year.