Medicare Decision Guide · Central Florida
Medicare Open Enrollment Checklist: 10 Things to Review Before You Keep or Change Your Plan
When a Medicare plan worked well this year, it may feel easier to let it renew automatically. But a plan that was a good fit in 2026 may not be the best fit in 2027. Drug lists, pharmacies, provider networks, copayments, premiums and extra benefits can change—and your own health needs may have changed too.
Before keeping or changing your Medicare coverage, compare your current plan with the 2027 options available in your ZIP code. Review all prescriptions, doctors, hospitals, total estimated costs and coverage rules—not just the monthly premium.
Medicare’s Annual Open Enrollment Period runs from October 15 through December 7, 2026. Changes made during this period generally take effect January 1, 2027.
Your 10-Point Medicare Open Enrollment Checklist
1. Read your Annual Notice of Change
Your Medicare Advantage or Part D plan should send an Annual Notice of Change describing changes that begin in January. Compare it with the coverage you used this year.
Look for changes to:
- Monthly premiums and deductibles
- Copayments and coinsurance
- Covered services and prescription drugs
- Pharmacy and provider networks
- Prior-authorization requirements
- Extra benefits
Do not assume that no news means no changes. If you did not receive the notice, contact your plan and ask for a copy.
2. Make a complete list of your prescriptions
Write down every medicine you take, including the exact name, dosage, quantity and how often it is refilled. Then confirm that each drug is on the plan’s 2027 formulary.
Also check:
- The drug’s coverage tier
- Your estimated copayment or coinsurance
- Whether prior authorization is required
- Whether step therapy or quantity limits apply
- Whether a lower-cost alternative should be discussed with your prescriber
A plan with a low premium can still cost more overall if one important medicine is expensive or restricted.
3. Check your preferred pharmacies
One pharmacy may cost less than another under the same Part D or Medicare Advantage plan. Confirm whether your usual pharmacy is in the network and whether it is listed as a preferred pharmacy.
Compare retail and mail-order costs when appropriate. Do not change how you take a medicine without first speaking with your doctor or pharmacist.
4. Confirm every important doctor and hospital
If you have a Medicare Advantage plan, check whether your primary doctor, specialists, hospital, laboratory, rehabilitation provider and other important facilities expect to participate in the plan in 2027.
Use both sources: ask the plan and call the provider’s office. Provider directories can change, and office staff should verify the exact plan name—not only the insurance company.
5. Compare total yearly costs—not only the premium
Add up what you may pay for the entire year:
- Plan premium
- Deductibles
- Doctor and specialist visits
- Hospital and outpatient care
- Prescription drugs
- Tests, therapy and medical equipment
- Out-of-network care, if applicable
For Medicare Advantage, review the annual out-of-pocket maximum for Part A and Part B services. Think about both a typical year and a year in which you need more care than expected.
6. Review referrals and prior authorization
Ask whether the plan requires referrals to see specialists or advance approval for services, procedures, medicines, therapy, equipment or skilled nursing care.
If you are receiving ongoing treatment, confirm how the plan will handle that care after January 1. A benefit is most useful when you understand the rules for receiving it.
7. Recheck dental, vision, hearing and other extra benefits
Some Medicare Advantage plans offer benefits such as dental, vision, hearing, transportation, fitness programs or over-the-counter allowances. Review the details rather than the headline amount.
Ask:
- Which providers may be used?
- Is there an annual limit?
- What services or products are excluded?
- Is prior approval required?
- Will the benefit realistically help you?
Extra benefits can be valuable, but they should not outweigh access to your doctors, prescriptions and essential medical care.
8. Consider travel and time away from home
If you spend part of the year outside Central Florida, visit family in another state or travel frequently, check how routine, urgent and emergency care will be covered.
Original Medicare and Medicare Advantage have different provider-access rules. Medicare Advantage HMO and PPO plans may also handle out-of-network care differently.
9. Review plan quality and service
Medicare Star Ratings can help you compare health and drug plans on quality and performance. Also think about your own experience:
- Were claims handled correctly?
- Could you reach customer service?
- Were medications or services delayed?
- Did you have trouble getting appointments or approvals?
A plan’s benefits on paper are only part of the decision.
10. Get help before making a final decision
You do not have to sort through every choice alone. Use Medicare’s official Plan Compare tool or call 1-800-MEDICARE (1-800-633-4227). Florida residents can also contact SHINE through the Elder Helpline at 1-800-963-5337 for free, unbiased and confidential Medicare counseling.
If you work with an insurance agent or broker, ask which insurance companies and plans the person represents. An agent may not represent every option available in your area.
What Changes Can You Make During Annual Open Enrollment?
Depending on your current coverage, you may be able to:
- Switch from Original Medicare to a Medicare Advantage plan
- Switch from Medicare Advantage back to Original Medicare
- Change from one Medicare Advantage plan to another
- Join, change or drop a stand-alone Medicare drug plan
- Add or drop drug coverage as permitted
Be careful when leaving Medicare Advantage for Original Medicare. If you want a Medigap policy, federal guaranteed-issue protections may not apply in every situation, and medical underwriting or other state-specific rules may affect availability or cost. Check your rights before ending existing coverage.
A Simple Way to Compare Plans
Create one page for each plan you are considering. Write down:
- Your doctors and hospitals
- Your prescriptions and preferred pharmacy
- Expected yearly medical and drug costs
- The out-of-pocket limit
- Referral and authorization rules
- Extra benefits you are likely to use
- Coverage while traveling
This turns a stack of brochures into a side-by-side decision based on your actual needs.
Central Florida Help and Official Resources
- Medicare Open Enrollment
- Medicare Plan Compare
- Compare Original Medicare and Medicare Advantage
- Florida SHINE Medicare counseling
Before December 7
Give yourself time to confirm details directly with the plan, pharmacy and healthcare providers. Keep notes about whom you spoke with and the date. Save confirmation of any enrollment request.
The goal is not to find the plan with the flashiest extras. It is to choose coverage that fits your prescriptions, healthcare providers, budget and life for the coming year.
Medical Health Reports reviewed current information from Medicare and Florida SHINE. Plan benefits, networks, formularies, costs and enrollment rules can change; confirm current details directly before making a coverage decision.
Medical Health Reports provides general educational information and does not offer medical, legal or insurance advice. Plan benefits, provider networks, formularies and costs can change. Verify current details with Medicare, the plan and your healthcare providers before enrolling or changing coverage.