Medicare Open Enrollment 2026: What You Need to Know

Every fall, Medicare beneficiaries across New Jersey have a brief but important opportunity to review and change their coverage. The Annual Enrollment Period (AEP) runs from October 15 through December 7, and any changes you make take effect January 1. Miss this window, and you may be locked into your current plan for another full year.

Many people assume their plan from last year is still the best choice. That assumption costs some beneficiaries hundreds — or even thousands — of dollars. Plans change their premiums, drug formularies, and provider networks every year. A drug that was covered at Tier 2 last year might jump to Tier 4. Your doctor might leave the plan's network. Your premium could increase significantly.

This guide will help you understand exactly what you can do during AEP, what to watch out for, and how to make sure you start 2026 with the right plan.

What Is the Annual Enrollment Period?

The AEP (also called Open Enrollment) is the one time each year when anyone with Medicare can make broad changes to their coverage. You do not need a qualifying life event to use it — everyone gets this window every year.

Here is a quick summary of what you can do during AEP:

• Switch from Original Medicare (Parts A + B) to a Medicare Advantage plan
• Switch from a Medicare Advantage plan back to Original Medicare
• Switch from one Medicare Advantage plan to a different one
• Join a Medicare Part D prescription drug plan for the first time
• Switch from one Part D plan to a different one
• Drop your Part D coverage entirely (not usually recommended)

The Annual Notice of Change (ANOC)

Every September, your insurance plan is required by CMS to send you an Annual Notice of Change (ANOC). This document shows exactly what is changing in your plan for the upcoming year — premiums, deductibles, copays, drug formulary changes, and any provider network updates.

Most people glance at it and set it aside. That's a mistake. The ANOC is your roadmap for whether to stay or switch. Read it carefully, especially the sections on:

• Premium changes — even a $20/month increase adds up to $240/year
• Drug formulary changes — check each medication you take and its new tier or any coverage restrictions
• Network changes — confirm your primary care doctor, specialists, and preferred hospital are still in-network
• MOOP (Maximum Out-of-Pocket) limit — this is your catastrophic protection; lower is better

Common Mistakes to Avoid

1. Assuming your current plan is still the best

Just because a plan worked well last year doesn't mean it's still the best option. Medicare Advantage and Part D plans re-file with CMS every year and can significantly change their terms. At the same time, new plans enter the market that may offer better coverage at lower cost.

2. Not checking your medications

Prescription drug coverage is often the most financially significant factor in plan selection. If a drug you rely on moves to a higher tier or gets removed from the formulary, your out-of-pocket costs can jump dramatically. Always run a formulary check before the new year.

3. Waiting until the last week

The final days of November and early December are the busiest time of year for Medicare agents. Plans can have application processing delays. If something goes wrong with your enrollment, there may not be enough time to fix it before December 7.

4. Enrolling in the first plan you're shown

TV ads and mail solicitations are everywhere in October. The most advertised plan is rarely the best plan for your specific situation. Your medications, doctors, and budget all matter.

What to Do Before You Decide

• Make a list of every prescription you take — including dosage and frequency
• List the doctors, specialists, and hospitals you want to keep using
• Estimate your likely healthcare use for next year (upcoming procedures, regular appointments)
• Review your ANOC carefully and note anything that changed
• Compare available plans at medicare.gov/plan-compare or work with a licensed agent

The Medicare Advantage Open Enrollment Period (January 1–31)

If you enrolled in a Medicare Advantage plan during AEP and change your mind, you have a second chance. From January 1 through March 31, Medicare Advantage members can make one change: switch to a different MA plan, or drop MA and return to Original Medicare (and add a Part D plan). You cannot use this window to switch from Original Medicare to MA.

Bottom Line

Open enrollment is not something to skip. Spend an hour reviewing your ANOC, check your formulary, confirm your doctors are still in-network, and compare your options. If you'd like help, our licensed agents in New Jersey review plans across all available carriers at no cost to you.

Disclaimer: This article is for educational purposes only and does not constitute insurance or financial advice. Coverage details, costs, and eligibility vary by plan and individual situation. Always consult a licensed insurance professional and verify current information with the plan or CMS before making enrollment decisions.