What Should a Caregiver Do During Medicare Open Enrollment? (2026)

Medicare open enrollment runs October 15 through December 7, with changes effective January 1 (Medicare.gov). The caregiver's checklist: read the Annual Notice of Change that arrived in September, build your parent's exact drug and doctor list, compare plans at Medicare.gov/plan-compare, and enroll before December 7. In 2026, shrinking extras, OTC benefits fell from 79% to 68% of enrollees' plans, make re-checking more important than usual (KFF).

Every fall, the same quiet transaction happens in millions of households: a plan mails a notice describing how it will get more expensive or less generous in January, and nobody reads it. The plan is not counting on your parent's satisfaction, it is counting on inertia.

A caregiver's job in October is to be the anti-inertia. The work fits into two evenings if you follow a sequence.

When is Medicare open enrollment and what can my parent change?

Open enrollment, formally the Annual Election Period, runs October 15 through December 7 every year. Your parent can switch Medicare Advantage plans, join or change a Part D drug plan, move from Original Medicare to Medicare Advantage, or drop Medicare Advantage for Original Medicare. Every change takes effect January 1 (Medicare.gov).

Two boundaries to know before you start:

• Medigap is not part of this window. Open enrollment covers Medicare Advantage and drug plans. A parent leaving Medicare Advantage for Original Medicare may face medical underwriting for a Medigap supplement in most states, check Medigap rules before making that particular move.
• The window is use-it-or-wait. Miss December 7 and the next general opportunity is the narrower January 1 to March 31 switch window (covered below), which only helps people already in Medicare Advantage.

The last change submitted before December 7 is the one that counts, so an early decision can still be revised if November brings new information.

What should I gather before comparing plans?

Three lists, gathered in about 30 minutes: every drug your parent takes (name, dose, quantity per month), every doctor and facility they want to keep, and the September Annual Notice of Change showing what their current plan will cost next year. Plan comparison without these lists produces confident, wrong answers.

• The drug list is the decisive input. Two plans with identical premiums can differ by thousands of dollars a year on the same prescriptions once tiers, deductibles, and pharmacy networks are applied. Pull the list from the pharmacy printout or the parent's Medicare.gov account rather than memory, the forgotten eye drops and the as-needed inhaler move rankings.
• The doctor list catches network surprises. Confirm the primary care doctor, every specialist, the preferred hospital, and, often forgotten, the dialysis center, infusion clinic, or physical therapist your parent uses.
• The Annual Notice of Change is the baseline. It arrived by September 30 and shows current-plan changes side by side (Medicare.gov). Highlight any drug moving tiers, any premium change, and the new maximum out-of-pocket.

With the three lists in hand, the actual comparison is mechanical.

How do I compare plans for my parent on Plan Finder?

Use Medicare.gov/plan-compare, enter your parent's ZIP code and full drug list, and sort results by "lowest drug + premium cost", total annual cost, not monthly premium. Then eliminate any plan that excludes your parent's doctors or pharmacy, and compare the survivors on the maximum out-of-pocket.

The order of operations matters because the flashiest number, the premium, often $0, is the least informative. In 2026 the average Medicare Advantage enrollee pays about $15 a month in premiums, but average in-network out-of-pocket limits run $5,421, and federal rules allow up to $9,250 in-network ($13,900 combined) (KFF). A $0-premium plan with a $9,000 ceiling is a different product from a $30 plan with a $4,000 ceiling, the difference only shows up in a bad health year, which is exactly the year that matters.

Practical Plan Finder notes for caregivers:

• Log in through your parent's Medicare.gov account if possible, saved drug lists carry over year to year.
• Check the pharmacy setting: mail-order versus retail and "preferred" versus "standard" pharmacies change drug costs substantially.
• For each finalist, open the plan's own site to verify doctors, Plan Finder directories lag. Call the doctor's office as the tiebreaker; ask "are you in-network with this specific plan for 2027?"
• If your parent has Original Medicare plus a standalone drug plan, run the same comparison for Part D only, drug plans change formularies annually, and the Part D out-of-pocket cap is $2,100 in 2026 with a base premium around $38.99.

What changed in 2026 that makes re-shopping worth it?

Extra benefits quietly shrank in 2026: the share of individual-plan enrollees with OTC allowances fell from 79% to 68%, transportation from 28% to 22%, bathroom safety devices from 32% to 21%, and meal benefits from 70% to 65% (KFF). A plan that "kept the same premium" may have paid for it by cutting the extras your parent actually uses.

The pattern across the 2026 market, per KFF's analysis: core medical benefits held steady, dental (98%), vision (99%), hearing (95%), and fitness (91%) remain near-universal in individual plans, while the newer, cash-like benefits contracted. Grocery and produce benefits now reach only 8% of individual-plan enrollees, down from 16% of enrollees in 2023, though they remain nearly universal (93%) in Special Needs Plans for low-income beneficiaries.

For a caregiver, that means two specific checks this fall:

1. If your parent relies on an extra, the quarterly OTC allowance, rides to dialysis, the grocery card, confirm in the ANOC that it survives into next year, and at what dollar amount. These allowances are exactly where plans cut quietly. Our guide to unused Medicare benefits covers what the extras are worth and how to use them.
2. If prior authorization burned your parent this year, weigh it in the comparison: 99% of Medicare Advantage enrollees are in plans requiring prior authorization for some services, and requirements vary meaningfully between plans (KFF).

Should we use a broker, a SHIP counselor, or do it ourselves?

Do the Plan Finder comparison yourself, then validate the finalists with a SHIP counselor, free, trained, and paid by no plan. Brokers can be useful for enrollment logistics, but they are compensated by insurers and cannot sell every plan in your market, including some strong ones.

The three channels, honestly compared:

• Yourself, on Plan Finder. Sees every plan, uses your parent's real drug data, costs nothing. The gap: interpreting edge cases (Medigap underwriting, retiree coverage interactions, dual-eligibility).
• SHIP counselors, the State Health Insurance Assistance Program, fill exactly that gap with free one-on-one counseling and no sales relationship. October appointments go fast; book early.
• Brokers are paid per enrollment by plans, with compensation structures that reward Medicare Advantage over other options, and they can only show contracts they hold. That does not make every broker wrong, it makes their incentives worth understanding before the conversation. We wrote the full breakdown in How Medicare Advantage Broker Pay Really Works.

A reasonable division: caregiver runs the numbers, SHIP validates, and the enrollment itself happens on Medicare.gov or through 1-800-MEDICARE, both of which see every plan and earn nothing from the choice.

What if we miss the December 7 deadline?

If your parent is in a Medicare Advantage plan, the Medicare Advantage Open Enrollment Period runs January 1 through March 31: one switch to another MA plan, or a move to Original Medicare plus a drug plan (Medicare.gov). Outside that, changes generally require a Special Enrollment Period.

The January-March window is a genuine safety valve, with limits: it is one change only, it does not allow switching between standalone drug plans for people on Original Medicare, and Medigap underwriting still applies in most states for those leaving Medicare Advantage.

Special Enrollment Periods cover the big life events, moving out of the plan's service area, losing employer coverage, entering or leaving a nursing home, gaining or losing Medicaid or Extra Help. Parents with Medicaid or Extra Help have substantially more flexibility to change plans during the year. If a bad plan is causing real harm and no window is open, call your SHIP, counselors know the SEP catalog and the exceptions.

The honest summary: the January window fixes a bad Medicare Advantage choice, but nothing fully substitutes for doing the comparison in the fall.

How do I protect my parent from enrollment-season scams?

Open enrollment is peak season for Medicare fraud. The rules that cut through every scam: Medicare does not call, text, or email your parent to sell or "verify" anything; legitimate enrollment happens through Medicare.gov, 1-800-MEDICARE, or an agent your family contacted first; and no real program requires a payment or gift card to "activate" benefits (FTC).

The fall pattern, documented by the FTC and the AARP Fraud Watch Network: ads and calls promising oversized "flex cards," free groceries, or premium refunds, designed to harvest Medicare numbers, which are then used for billing fraud. A Medicare number is as valuable as a credit card number and should be treated the same way.

Three defenses to set up with your parent this October:

1. A no-decisions-on-inbound-calls rule. Anything legitimate can be verified by hanging up and calling 1-800-MEDICARE or the number on the plan card.
2. You as the second set of eyes. Any enrollment change goes through the caregiver before a signature or a recorded "yes." Scammers and aggressive salespeople both rely on same-call decisions.
3. Report attempts to 1-800-MEDICARE and the AARP helpline at 877-908-3360, reports are how patterns get shut down.