3 Medicare Assumptions You Need to Clear Up Before Open Enrollment

October is a big month for retirees. It's when the Social Security Administration typically announces a cost-of-living adjustment, and it's when Medicare open enrollment begins.

Medicare open enrollment runs annually from Oct. 15 through Dec. 7. During this time, current enrollees can make changes to their coverage. That could mean switching from one Part D drug plan to another or moving onto a new Medicare Advantage plan.

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It's important to go into open enrollment with an open mind. And that means moving past these big misconceptions.

1. If my plan worked well this year, it should work next year

You might assume that if you're happy with your current Medicare plan, there's no reason to make a switch. But Medicare plans can change from one year to the next. A specialist you see often could move out of network. Or a prescription you take could shift to a different tier in your plan's formulary, resulting in more expensive copays.

Before you decide to stick to the same Medicare plan, review its annual notice of change, which should arrive by the end of September. Then, once you see how your plan is changing, compare it to other options available in your area. You may find that a new plan offers more affordable coverage or better access to the providers you want to see.

2. My spouse and I should be on the same Medicare plan

Being on the same Medicare plan as your spouse might be convenient. But it's not something you have to do. And if you have very different medical needs, it could be a poor choice.

Rather than assume you and your spouse should enroll in the same plan, review your choices based on your individual needs. A Part D plan that's cheaper for one of you may be needlessly expensive for the other.

3. If I'm used to original Medicare, I should stick with it

The nice thing about original Medicare is that you can typically see any doctor in the U.S. who accepts Medicare as insurance. But there can be an upside to enrolling in a Medicare Advantage plan. These plans commonly offer supplemental benefits beyond what original Medicare offers, which could lead to cost savings and improved coverage.

This doesn't mean Medicare Advantage is the right choice for you. What it does mean, though, is that it's worth exploring Advantage plans in your area to see what benefits they offer and what your costs might be.

The choices you make during open enrollment could have an impact on your health coverage and finances in 2027. So it's important to go in without these assumptions holding you back.

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