Reviewing Options During Medicare Open Enrollment
Courtney M. Buechler, Esq., MPH | Attorney, Elder Law and Estate Planning
Christina Herold | Paralegal, Elder Law and Estate Planning
Medicare Open Enrollment is an annual opportunity to explore your current medical coverage options and ensure you have the best health and prescription drug coverage to meet your needs. The official enrollment period runs from October 15 through December 7, 2026, for coverage to begin January 1, 2027. During Open Enrollment, you can enroll in Medicare for the first time, switch between Original Medicare and Medicare Advantage, change Medicare Advantage plans, or join, switch, or drop a Part D prescription drug plan. If you are considering a change, mark your calendar and avoid making a last-minute decision.
Why Should I Review My Medicare Coverage Annually?
Your current coverage may still be the best fit for your needs and budget, but it is worth taking a fresh look to make sure. For example, your income may have changed, your healthcare needs may be more focused, your prescriptions may be different, or your preferred doctors or pharmacies may no longer be covered the same way. Plans can also change their premiums, out-of-pocket costs, and covered benefits from one year to the next. Taking time to review your coverage helps you decide with confidence.
If you’re helping a parent or another family member with Medicare, reviewing their coverage together can also be a practical way to make sure they have the benefits they need for the year ahead. It can also open the door to broader conversations about long-term care, financial security, and legacy planning. Taking a more comprehensive look at these issues while there is time to plan can help you understand one another’s wishes, consider available options, and make thoughtful decisions together rather than having to work through difficult questions when circumstances leave fewer choices.
Pennsylvanians can connect with trained, unbiased counselors through the official PA MEDI Medicare Counseling Program for help comparing plans.
Should I Choose Medicare Advantage or Original Medicare?
Medicare Advantage plans often have low or no monthly premiums, which makes them appealing. Many people choose a Medicare Advantage plan based on premium alone without comparing it to Original Medicare paired with a Medigap (Medicare Supplement) policy. A lower premium can cost more in the end if a plan shifts expenses to you through copayments, coinsurance, network restrictions, or prior authorization requirements that limit your access to care.
For many people, Original Medicare (Parts A and B) paired with a carefully chosen Medigap policy is a reasonable starting point. Medigap policies are standardized (Plans A through N), so benefits are generally the same for the same plan letter, although premiums vary by insurer. Switching from Medicare Advantage back to Original Medicare with a Medigap policy later can be harder than many people expect, which makes your first choice especially important. The right choice depends on your health needs, providers, medications, and overall financial circumstances.
For an explanation of what each part of Medicare covers, read Making Sense of Medicare: Understanding Your Benefits and Planning Ahead. To compare specific plans in your area, use the Medicare Plan Finder at Medicare.gov.
How Does Income Affect Medicare Premiums?
Changes in your income from one year to the next can also affect your premiums. The Income-Related Monthly Adjustment Amount (IRMAA) increases Part B and Part D premiums for higher-income beneficiaries, generally based on tax information from two years prior. The Centers for Medicare & Medicaid Services (CMS) publishes annual IRMAA brackets and amounts based on defined income tiers.
For the official breakdowns and thresholds, refer to the CMS 2026 Medicare Premiums and Deductibles Fact Sheet.
How Can an Elder Law Attorney Help During Open Enrollment?
If you are unsure where to begin, consider speaking with an elder law attorney who is well versed in Medicare options and can provide unbiased counseling to help you compare your choices with your desired future health needs and long-term care and estate planning goals. While physicians manage your care and may provide input on choosing a plan, an elder law attorney looks at the bigger picture, ensuring your healthcare choices align with your estate planning goals. This is also a good time to consider things like how you would pay for long-term care if the need arises, whether your current financial arrangements support your future needs, and what you would like to leave behind for the people and causes that matter to you.
CGA’s elder law attorneys can help. We serve clients from offices in York, East Berlin, Hanover, Red Lion, Gettysburg, and Lancaster.
To schedule a consultation, call (717) 848-4900 or contact us online.
Courtney M. Buechler, Esq., MPH, is a CGA attorney who advises clients on elder law, estate planning, and estate administration. She holds a J.D. from Penn State Dickinson Law and a Master of Public Health. She is licensed in Pennsylvania and Maryland and serves clients from CGA’s York, East Berlin, Hanover, and Red Lion offices.
Christina Herold is a CGA paralegal with over 25 years of experience supporting clients in PA, NJ, NY, and FL. She holds an Associate of Applied Science degree in Paralegal Studies and assists clients with estate planning, estate administration, and elder law across all CGA locations.
