Open Enrollment Period 2026
Healthcare costs and plan details change every year, and staying on top of your Medicare coverage is one of the best ways to protect both your health and your wallet. One of the biggest sources of confusion is when you are actually allowed to make changes to your coverage.
People frequently mix up the fall Annual Election Period (AEP) with the winter Medicare Advantage Open Enrollment Period (OEP), even though these windows happen at different times and allow different kinds of changes. In 2026, understanding this difference—and the fast‑approaching March 31 Medicare Advantage OEP deadline—is critical.
Understanding the Medicare landscape
When you turn 65 (or earlier if you qualify through disability), you generally have two main paths for your Medicare coverage:
1. Original Medicare (federal program)
Original Medicare is the traditional, fee‑for‑service program run by the federal government and includes:
Part A (Hospital Insurance) – inpatient hospital stays, skilled nursing facility care, some home health, and hospice.
Part B (Medical Insurance) – doctor visits, outpatient care, preventive services, durable medical equipment, and more.
Because Original Medicare leaves you responsible for about 20% coinsurance on many Part B services with no annual out‑of‑pocket maximum and does not include outpatient drug coverage, most people add:
A Medigap (Medicare Supplement) policy to help cover deductibles, coinsurance, and other gaps.
A standalone Part D prescription drug plan for medications.
2. Medicare Advantage (Part C)
Medicare Advantage is an “all‑in‑one” alternative to Original Medicare offered by private insurance companies approved by Medicare. When you join a Medicare Advantage plan:
You still have Medicare, but you get your Part A and Part B benefits through the private plan instead of directly from the federal government.
Most plans are HMOs or PPOs and usually include Part D prescription drug coverage, plus extra benefits such as dental, vision, hearing, or fitness programs.
You generally must use the plan’s network (except in emergencies) and follow its rules for referrals, prior authorizations, and covered services.
The two key annual enrollment windows
If you want to change your Medicare coverage, you usually must wait for a specific enrollment period—unless you qualify for a Special Enrollment Period due to a life event such as a move or loss of other coverage.
The Annual Election Period (AEP): October 15 – December 7
AEP happens every fall, from October 15 through December 7. During AEP, anyone with Medicare can make broad changes that take effect January 1 of the coming year, including:
Switch from Original Medicare to a Medicare Advantage plan.
Switch from Medicare Advantage back to Original Medicare.
Join, drop, or change a standalone Part D prescription drug plan (for those in Original Medicare).
Switch from one Medicare Advantage plan to another, with or without drug coverage.
Because AEP changes take effect on January 1, this is when many beneficiaries end up in a new Medicare Advantage or Part D plan for the first time.
The Medicare Advantage Open Enrollment Period (OEP): January 1 – March 31
The Medicare Advantage Open Enrollment Period runs each year from January 1 through March 31. This period is much more limited and is designed specifically for people who start the year in a Medicare Advantage plan:
If you already have a Medicare Advantage plan on January 1, you can use this period once to correct a plan choice that is not working well.
If you are new to Medicare and first enroll in a Medicare Advantage plan when you start Medicare, you also have a similar open enrollment window that runs from the first month you have both Part A and Part B through the end of your third month of entitlement.
During the January 1–March 31 Medicare Advantage OEP, you may:
Switch to a different Medicare Advantage plan, with or without drug coverage.
Drop your Medicare Advantage plan and go back to Original Medicare, and, if you do, you can join a standalone Part D plan.
You cannot use this period to:
Switch from Original Medicare into a Medicare Advantage plan.
Switch from one standalone Part D plan to another if you are in Original Medicare.
In other words, OEP is mainly a “safety valve” for people who discover early in the year that their current Medicare Advantage plan is not a good fit.
Why you must act before March 31, 2026
If you are currently enrolled in a Medicare Advantage plan, March 31, 2026 is your hard deadline to make a one‑time change using the Medicare Advantage OEP for this year.
This is especially urgent because many people only discover problems after they start using their new plan in January or February, such as:
A favorite doctor, specialist, or hospital is no longer in‑network.
A necessary medication is off the formulary entirely or placed on a much higher tier, making copays or coinsurance far more expensive.
Extra perks like dental, vision, hearing, or over‑the‑counter allowances are harder to use or more limited than the marketing suggested.
If you run into issues like these and wait too long:
You must use your one allowed OEP change by March 31, 2026, for it to take effect in 2026.
If you miss this window and do not qualify for a Special Enrollment Period, you will generally be locked into your current Medicare Advantage plan for the rest of 2026.
Because the stakes are high—access to your doctors, medications, and predictable costs—it is wise to review your early‑year experiences with your plan and decide before March 31 whether a change is needed.
What’s new in Medicare for 2026?
If you are evaluating your costs during this enrollment window, several important 2026 Medicare cost changes and drug‑benefit improvements are already finalized.
2026 Part A and Part B standard costs
For 2026, the Centers for Medicare & Medicaid Services (CMS) announced the following standard Medicare costs:
Standard Part B premium: $202.90 per month.
Part B annual deductible: $283 for the year.
Part A inpatient hospital deductible: $1,736 per benefit period.
The Part A deductible applies separately to each benefit period, which starts when you are admitted as an inpatient and ends after you have been out of a hospital or skilled nursing facility for 60 consecutive days.
The Inflation Reduction Act and Part D in 2026
The Inflation Reduction Act (IRA) continues to deliver major savings for people with Medicare drug coverage in 2026.
Key features for 2026 include:
Annual out‑of‑pocket cap of $2,100 for Part D drugs.
In 2025, the IRA introduced a $2,000 annual cap on out‑of‑pocket costs for covered Part D drugs; this cap is indexed over time. For 2026, the cap increases to $2,100, meaning once your true out‑of‑pocket spending on covered Part D drugs reaches that amount in 2026, you will not owe any more cost sharing for covered Part D drugs for the rest of the year.
$35 monthly cap for covered insulin.
Under the IRA, Part D plans (and Medicare Advantage plans with drug coverage) must cap copays for covered insulin products at no more than 35 for a one‑month supply, with no deductible applied, and this requirement continues into 2026.
$0 copay for recommended adult vaccines.
Adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) and covered under Part D—such as the shingles vaccine (Shingrix)—must be covered without any deductible or cost sharing, and this continues in 2026.
Medicare Prescription Payment Plan (cost‑smoothing).
Starting in 2025, all Part D plans (standalone and Medicare Advantage) must offer the Medicare Prescription Payment Plan, which allows you to spread your out‑of‑pocket Part D drug costs over the year in equal monthly payments instead of paying large costs all at once at the pharmacy counter. This option remains available in 2026.
These changes make it much easier to predict and manage prescription drug costs, especially for people taking expensive brand‑name or specialty medications.
Frequently asked questions
Q: I have Original Medicare and a Medigap policy. Does the January 1 – March 31 Medicare Advantage OEP apply to me?
A: No. The January 1–March 31 Medicare Advantage Open Enrollment Period is only for people who are enrolled in a Medicare Advantage plan at the start of the year (or who are newly entitled and enrolled in a Medicare Advantage plan during their first months of Medicare). If you have Original Medicare plus Medigap, you cannot use this OEP to change your Medigap or to join a Medicare Advantage plan—you would instead use AEP or, in some cases, a Special Enrollment Period.
Q: Do I need to re‑enroll in Medicare every year?
A: No. Once you are enrolled in Medicare Part A and Part B, you generally stay enrolled automatically each year as long as you continue to pay any required premiums. Enrollment periods like AEP and the Medicare Advantage OEP are simply opportunities to change your private plan coverage (Medicare Advantage, Part D, Medigap), not to re‑qualify for Medicare itself.
Q: Are expensive drugs not covered by Part D?
A: Part D plans must follow federal rules, including:
Covering at least two drugs in every therapeutic category.
Providing coverage for all drugs in six “protected classes,” such as many cancer drugs, HIV medications, and certain mental health treatments.
However, each plan has its own formulary (list of covered drugs) and may place expensive drugs on higher tiers with higher copays or require prior authorization or step therapy. If a needed drug is not on your plan’s formulary, you and your prescriber can request a formulary exception or consider switching to a different plan during an appropriate enrollment period.
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