Calculator, reading glasses, pen, coins and a notepad on a white wooden table

Medicare Open Enrollment: A Yearly Chance to Trim a Big Bill

ByHarold Jennings

Every fall, people with Medicare get a short window to look at their health and drug coverage and change it for the coming year. It runs from October 15 to December 7. For many households, health coverage is one of the biggest monthly bills, so this is a good moment to make sure you are not paying more than you need to.

On Replace a Bill, we usually talk about earning a little extra to cover one bill. But trimming a bill first means you need less side income to cover it. Medicare Open Enrollment is one of the best yearly chances to do that. This guide explains, step by step, what to check, where to get free help, and which programs may lower your costs.

This is general information, not advice about your own plan. Medicare choices depend on your health, your medicines and your budget, and the free counselors mentioned below can help you weigh them.

What you can change during Open Enrollment

According to Medicare.gov, between October 15 and December 7 you can:

  • Switch from Original Medicare to a Medicare Advantage Plan, or from a Medicare Advantage Plan back to Original Medicare.
  • Join, drop or switch Medicare Advantage Plans, with or without drug coverage.
  • Join, drop or switch a Medicare drug plan (Part D) if you have Original Medicare.

Your plan must receive your request by December 7. New coverage starts January 1. If you make more than one change during the window, only the last one takes effect.

If you are happy with your plan, you don’t have to do anything; you generally stay enrolled. But your plan’s costs and coverage can still change for next year, which is why it pays to look.

Step 1: Read your plan’s “Annual Notice of Change”

If you have a Medicare Advantage or Part D drug plan, your plan should have sent you a letter called the Annual Notice of Change by September 30, according to the National Council on Aging. It may come by mail or email, and plans usually post it on their websites too. If you can’t find it, call the number on your plan card and ask for a copy.

The letter lists what is changing on January 1. Look for:

  • The monthly premium: will it go up, stay the same or go down?
  • The drug deductible: the amount you pay before the plan starts sharing costs.
  • Your medicines: are they still on the plan’s drug list (the “formulary”)? Has any moved to a more expensive tier?
  • Your pharmacy: is it still in the plan’s network?
  • Your doctors and specialists: are they still in network, and have visit copays changed?
  • The yearly out-of-pocket maximum and any extras, such as dental, vision or hearing benefits.

A pencil and highlighter help here. Circle anything that will cost you more.

Step 2: Make a short list of what matters to you

Before you compare plans, write down a few things on one sheet of paper:

  • Every prescription you take, with the dose and how often.
  • The pharmacy you use (and whether you would use mail order).
  • The doctors, specialists and hospital you want to keep.
  • What you paid in premiums and copays this year, if you know it.

This list makes the comparison much quicker, whether you do it yourself online or with a counselor.

Step 3: Compare plans with Medicare’s Plan Finder

Medicare.gov has a free tool called Plan Finder. You don’t need to create an account to use it, although an account lets you save your drug list for next time. Here is how it works, based on a step-by-step explanation in Medicare Interactive’s “Dear Marci” column:

  1. Go to medicare.gov/plan-compare.
  2. Choose to continue without logging in (or log in if you have an account).
  3. Enter your ZIP code and choose whether you are looking at Medicare Advantage plans or Part D drug plans.
  4. Type in your medicines one at a time and choose your pharmacies.
  5. Look at the results. They can be sorted by the lowest combined drug and premium costs, which gives you an estimate of what you might pay for the year.
  6. Open “Plan Details” for any plan you like to check its drug list, any limits on your medicines, and its star rating.

Before you switch, call the plan you are considering to confirm that your medicines, pharmacy and doctors are covered. Online information can occasionally lag behind.

If you would rather not use a computer, you can call 1-800-MEDICARE (1-800-633-4227) and ask for help comparing plans.

Step 4: Get free, unbiased help from SHIP

Every state has a State Health Insurance Assistance Program, usually called SHIP. The National Council on Aging describes it as free, confidential, unbiased counseling, funded by the federal government and offered by trained staff and volunteers. SHIP counselors can help you understand your costs, compare Medicare Advantage and drug plans, and report possible Medicare fraud.

Your state’s program may have a different name, such as HICAP, SHIBA, APPRISE or CHOICES. To find yours:

  • Visit shiphelp.org and use the SHIP locator.
  • Or call the SHIP national center toll-free at 1-877-839-2675.

Appointments can fill up as December gets closer, so it helps to call early in the window.

Step 5: See if you qualify for help paying costs

Two programs can lower Medicare costs for people with limited income and savings. Many people who qualify never apply, so it is worth a look.

Extra Help with drug costs

Extra Help is a Medicare program that lowers the cost of Part D drug coverage. Medicare.gov lists 2026 limits of $23,940 in yearly income and $18,090 in resources for one person, or $32,460 in income and $36,100 in resources for a married couple (Alaska and Hawaii differ). For 2027, it says people with Extra Help pay a $0 plan premium and $0 deductible on qualifying plans, and no more than $5.80 for each generic drug or $14.40 for each brand-name drug.

You can apply online at ssa.gov/medicare/part-d-extra-help, and a SHIP counselor can help you apply for free. If your situation changes, you can apply again at any time.

Medicare Savings Programs

Medicare Savings Programs are run by each state. Depending on the program, they can pay your Part B premium, and the most generous one also helps with deductibles, coinsurance and copays. For 2026, Medicare.gov lists monthly income limits for one person ranging from $1,350 to $1,816 for the three main programs, with a resource limit of $9,950. Some states don’t count certain income or savings, so Medicare.gov suggests applying even if you think you are slightly over.

You apply through your state’s Medicaid office, not through Medicare. Medicaid.gov has a page that points you to your state’s office. People who get a Medicare Savings Program, full Medicaid or SSI automatically qualify for Extra Help as well.

One thing to keep in mind as you build a side income: these programs look at your income and savings. Extra earnings could affect whether you qualify, now or later. If you are counting on one of these programs, ask your state office or a SHIP counselor how side income would be treated before you take on new work.

Watch out for Medicare scams this season

Scammers know that fall is a busy time for Medicare. The Federal Trade Commission offers these reminders:

  • Medicare won’t call, email, text or message you on social media out of the blue.
  • Medicare won’t ask for your Medicare number, Social Security number or bank details in an unexpected contact.
  • Medicare won’t try to sell you anything, and your Medicare card is free.
  • Be wary of a caller who mentions a “medical equipment claim” you don’t remember. Scammers use your Medicare number to bill for things you never got.
  • Caller ID can be faked. If a call seems real, hang up and call 1-800-MEDICARE yourself.

You can report a suspected Medicare scam to 1-800-MEDICARE. The FTC also suggests your local Senior Medicare Patrol for help preventing or reporting fraud.

After Open Enrollment ends

If you choose a new plan, keep the confirmation letter or number. Watch your mail for a new card, and bring it to your first pharmacy visit in January.

If you have a Medicare Advantage Plan, Medicare.gov says there is a second, smaller window from January 1 to March 31. During it, you can switch to a different Medicare Advantage Plan or go back to Original Medicare (and join a separate drug plan). That can help if a new plan turns out to be a poor fit.

How this fits the Replace a Bill idea

Whatever you save on premiums or drug costs is money you won’t need to earn. If a change saves even $15 or $20 a month, that may be enough to cover a phone line or a streaming plan, and your side income can move on to the next bill. Savings depend on your plan and your medicines, so treat any number as an estimate until you see your new costs.

More on Replace a Bill

Sources

Similar Posts