Whether you’re relatively new to Medicare or you’ve had coverage for years, Medicare open enrollment is critically important for both your health and your finances. Before starting the process, it can be helpful to review your options and learn about key changes for the year ahead. “We serve so many clients who access Medicare and Supplemental Coverage,” says Jesse Kuusisto, CFP®, Wealth Manager at Laurel Wealth Planning. “Both are such an important part of their financial plan.”
A Quick Look at Medicare Open Enrollment
Open enrollment goes from October 15 to December 7. This process gives you an opportunity to change your Medicare coverage for the next year. If you haven’t yet enrolled in Medicare, you’ll need to do so during your initial enrollment period, beginning three months before you turn 65 and ending three months after you turn 65. Jesse explains, “For folks moving toward age 65, starting Medicare enrollment three months before age 65 is important to make sure it’s in place and that you’ve chosen the right supplemental coverage and Part D coverage.” He adds, “Minnesota residents can get a lot of their questions answered at the Minnesota Aging Pathways (formerly the Senior LinkAge Line), a totally free service with a lot of expertise in Medicare and in particular medications and coverage.” Note: other states often offer their residents equivalent resources.
Medicare open enrollment allows you to make changes to the following kinds of coverage:
- Part A: Hospital insurance
- Part B: Medical insurance
- Part C: Medicare Advantage (private insurance that combines Part A, Part B, and additional benefits)
- Part D: Prescription drug coverage
The combination of Part A and Part B is sometimes referred to as “Original Medicare” or “Traditional Medicare.”
During Medicare open enrollment, you may make the following changes to your plan:
- Switching from original Medicare to Medicare Advantage (or vice versa)
- Switching from one Medicare Advantage plan to another
- Adding or dropping Part D coverage
- Switching between Part D plans
If you forget to update your coverage during Medicare open enrollment, don’t worry—you won’t lose Medicare coverage. Instead, your current coverage remains unchanged for the next year.
Medicare Open Enrollment for 2026: Important Changes
Each year, coverage options offered during Medicare open enrollment change slightly. However, 2026 is bringing major changes that could impact your future financial plans:
Certain Premiums Are Rising
Medicare Part B covers routine medical care, including primary care visits and some types of medical equipment. Many Medicare recipients rely heavily on it, but Part B is about to become less affordable. For 2026, premiums are set to rise by 11.6%, and the Part B annual deductible is set to increase by 12%. Premiums for Part D are predicted to increase by 6%.
Prescription Drugs Have a $2,100 Out-of-Pocket Spending Cap
Although some costs are increasing, Medicare is going to cap out-of-pocket spending on covered drugs at $2,100. That cap includes the following:
- Your deductible
- Any copays or coinsurance paid
However, you should keep in mind that the $2,100 cap applies only to prescription drugs covered by your plan. If some of your prescriptions aren’t covered, you may end up spending more than $2,100 on prescription drugs.
CDC-Recommended Vaccines Are Free
If you have Medicare Part D, any vaccines recommended by the CDC are available free of charge.
Insulin Might Be More Affordable
In 2026, you may be able to save even more on insulin. Previously, monthly out-of-pocket spending on insulin supplies was capped at $35. However, if you sign up for Part D during Medicare open enrollment, you’ll pay the lesser of these three options:
- $35
- 25% of the negotiated price under Medicare Advantage plans with prescription coverage or Traditional Medicare prescription drug plans
- 25% of the maximum fair price under the Medicare Drug Price Negotiation Program
Given the fact that healthcare costs are rising across the board, this change could help safeguard your access to life-saving medication.
Need Help Navigating Medicare Open Enrollment?
The decisions you make during Medicare open enrollment can shape your access to healthcare throughout the following year. If you have questions or are unsure whether you should make changes, help is available. The team at Laurel Wealth Planning is dedicated to helping retirees and pre-retirees make the decisions they need to thrive. Jesse Kuusisto brings nine years of experience to your financial planning and often supports clients in their Medicare decisions and direction, including planning to reduce premiums based on income.
To schedule a complimentary meeting, email laura.kuntz@laurelwealthplanning.com or call (952) 854-6250. Find out if the Laurel Wealth Planning team is the right financial advisor for you based on your wants and needs.
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