Medicare Open Enrollment: What You Need to Know for 2025–2026

Medicare Open Enrollment is just around the corner! This is the time of year when you can review your current plan, compare other options, and make changes to ensure your coverage best fits your health and financial needs.

🗓️ Key Dates

• Open Enrollment Period: October 15 – December 7, 2025Any changes you make during this time will go into effect January 1, 2026.

• Medicare Advantage Open Enrollment Period: January 1 – March 31, 2026During this period, you can switch from a Medicare Advantage Plan back to Original Medicare, but you cannot switch from one Advantage Plan to another.

💊 Don’t Forget About Part D (Prescription Drug Coverage)

If you decide not to sign up for a Part D plan when you first become eligible, you may face a lifetime penalty if you enroll later. After 63 days without creditable drug coverage, Medicare will add a penalty to your monthly premium for as long as you have a Part D plan.

Tip: Always include all your prescription medications when comparing plans—this ensures your prescriptions are covered and you’re getting the best deal possible.

📞 Who Can Help Me Choose or Change My Plan?

You don’t have to navigate Medicare alone! The following resources can help you compare plans and make the best decision for your needs:

• NEMO Area Agency on Aging (previously RSVP)📍 2815 N. Baltimore, Kirksville, MO☎️ (660) 665-4682

SHIP-Medicare open enrollment.pdf

Download PDF • 340KB

• Your Local Pharmacy — Some pharmacies offer assistance with plan selection.

• An Insurance Agent — Especially helpful for personalized guidance.

• Your Current Part D Provider — Call the member services number on the back of your card.

• Medicare.gov or 1-800-MEDICARE (1-800-633-4227)

  
  

💡 Medicare Extra Help Program

The Medicare Extra Help Program provides financial assistance for eligible individuals to help cover Part D prescription drug costs. This program can significantly reduce or even eliminate your monthly premiums, deductibles, and co-pays for prescription medications.

Eligibility & How to Apply:

• Eligibility is based on income and resources.

• You can apply through Social Security at www.ssa.gov or by calling 1-800-772-1213.

• Local agencies like the NEMO Area Agency on Aging can also assist with applications.

If you qualify, Extra Help can make your prescription medications much more affordable and reduce your out-of-pocket costs.

🧾 Changes Coming to Medicare in 2026

There are a few important updates taking effect in 2026:

• The annual out-of-pocket cap will increase from $2,000 to $2,100.

• The Part D deductible will increase from $590 to $615.(Note: Not all plans have a deductible—another reason to shop around!)

• More Medicare Advantage and Part D plans will be available in 2026, giving you more options than ever before.

  
  

💰 Could You Benefit from the Medicare Prescription Payment Plan?

Medicare’s Prescription Payment Plan helps spread out your drug costs throughout the year—so you don’t have to pay large amounts upfront at the beginning of the year.

Here’s how it works:

• You pay $0 at the pharmacy when picking up your prescriptions.

• Your plan sends you monthly bills, and you pay them directly.

• You must enroll in this plan—it doesn’t lower your drug costs, but it helps with cash flow by spreading payments evenly across the year.

• You can enroll at any time, and it’s available for Medicare Advantage plans too!

✅ Final Reminder

Take the time this fall to review your Medicare plan options carefully. A few minutes of comparison can lead to significant savings, better coverage, and possibly financial assistance through programs like Medicare Extra Help in 2026.

Who can I contact for more help?

Shelly Davis, LPN

Prescription Assistance Case Manager

Northeast Missouri Health Council Administration Building

1416 Crown Drive, Kirksville, MO 63501

Phone: 660-627-5757, ext. 1021