Medicare Open Enrollment: Why Doing Nothing Is Still a Decision
Friday, October 16, 2026
Medicare Open Enrollment begins every year on October 15. For many retirees, that date comes and goes with little attention because the current coverage seems to be working. But choosing to keep the same plan is still a decision, and it is a better decision when it follows a review.
Medicare Open Enrollment runs from October 15 through December 7, with changes generally taking effect January 1. During this period, beneficiaries may be able to switch Medicare Advantage plans, change prescription drug plans, move between Original Medicare and Medicare Advantage, or make other permitted coverage changes.
Start With the Annual Notice of Change
If you are enrolled in a Medicare plan, the Annual Notice of Change is one of the most important pieces of mail you receive in the fall. Plans send this notice in September to explain changes in coverage, costs and other plan features for the coming year.
Do not assume that the plan you have today will look exactly the same on January 1. Premiums can change. Copays can change. Drug formularies can change. Pharmacy relationships can change. Provider networks can change. A plan that was a good fit this year may still be a good fit next year, but that should be confirmed rather than assumed.
Prescription Coverage Deserves Special Attention
A common Medicare mistake is comparing plans based only on the monthly premium. Prescription drug costs can be affected by the specific medications you take, the pharmacy you use, plan formularies and cost-sharing rules.
That means two people living in the same ZIP code can have very different results with the same plan. A spouse may even be better served by a different plan than the other spouse because the medication lists are different. Medicare planning should be individualized to the person, not simply the household.
Doctors and Hospitals Matter Too
For Medicare Advantage enrollees, provider networks can be an important part of the review. A physician or healthcare system that participates today may not necessarily have the same relationship with a plan in the future. Confirming the doctors and facilities that matter to you is part of evaluating coverage.
People considering a move between Medicare Advantage and Original Medicare should also understand that Medigap rules can affect the decision. The ability to obtain a Medicare Supplement policy can depend on timing and individual circumstances, so switching coverage should not be treated as a simple premium comparison.
Medicare Is Also a Financial-Planning Issue
Healthcare choices are not isolated from the rest of retirement planning. Premiums and out-of-pocket expenses affect the retirement budget. Taxable income can affect Medicare income-related surcharges. A large Roth conversion, capital gain or retirement-account distribution may have consequences that reach beyond the income-tax return.
That does not mean retirees should avoid recognizing income. It means major tax decisions should be made with an understanding of their potential Medicare impact.
Do Not Wait Until December 7
The most effective Medicare review usually begins early in the enrollment period. Gather the current medication list, preferred pharmacies, physicians and expected healthcare needs. Review the Annual Notice of Change. Then compare the available choices with enough time to ask questions before the deadline.
Sometimes the right answer is to keep exactly what you have. But there is a difference between keeping a plan because you reviewed it and it still fits, and keeping it simply because another year passed.
How Otium Can Help
At Otium Financial Planners, Medicare and retirement healthcare planning are part of the broader retirement conversation. We can help clients identify the financial issues that should be reviewed during Open Enrollment, coordinate Medicare decisions with income and tax planning, and connect the healthcare piece with the rest of the retirement plan. The objective is to make coverage decisions with a clearer understanding of how they affect both healthcare and the household budget.
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