Medicare Open Enrollment: A Care-Needs Checklist (Oct 15 – Dec 7)

First, list the care you use now

Write down the care your loved one gets in a normal month. List home health visits, if any. List therapy, wound care, or nurse visits. List the equipment used at home, such as a walker, a bed, or oxygen. List rides to care, if the plan helps with them. Be honest about help with bathing, meals, and pills, even if family gives that help now. Family help can change fast. A plan choice that assumes family help will always be there is a risky choice. This list is your base. Every plan you look at must be tested against this list, not against a sales pitch.

Then, list what may change next year

Care needs rarely stay still. Think about the year ahead. Is surgery planned? Is a health problem getting worse? Has walking become less steady? Has memory slipped? New needs change which plan fits best. A plan with a strong home health network may matter more next year than it did last year. A plan with better drug coverage may matter if new medicines are likely. Write down the changes you expect, and mark the ones you are unsure about. Unsure items still count. They tell you to favor plans with some room to flex, rather than the tightest plan that only fits today.

Sample situation

Talia helps her mother, June, who lives at home and gets nurse visits for wound care. June also uses a walker and takes several medicines each day. When fall comes, Talia knows June may need more help next year. Walking has grown less steady, and a new medicine may be added soon.

Talia starts with the checklist. She writes down the care June uses now and the changes she expects. She lists each drug by name and dose and checks it in each plan she weighs. She calls June's doctors and home health agency to ask which plans they will work with next year. She also notes the standard Part B premium of $202.90/month for 2026 as a fixed point for her math, while she compares full year costs side by side, not just premiums.

She works through the list during Open Enrollment, from Oct 15 to Dec 7, and asks about help for low incomes before she decides. By the end, Talia has one clear page of notes and can choose a plan that fits June's real care, in line with the steps in this checklist.

Know the 2026 costs you can plan around

Some costs are set for 2026 and can anchor your math. The standard Part B premium is $202.90/month for 2026. The Part B deductible is $283 for 2026. For drug coverage, the Part D maximum standard deductible is $615 for 2026. The Part D out-of-pocket cap is $2,100 for 2026. After that cap, you pay nothing more for covered drugs that year. Covered insulin costs $35/month per product, and ACIP-recommended adult vaccines cost $0. These are 2026 figures. They help you judge this year's bills and compare plan types. They are not promises about 2027 plan prices, which each plan sets on its own.

The table below gathers those 2026 anchor costs in one place so you can use them while you compare plans.

In short, the table gives you fixed points in a season full of moving prices. Plan premiums and copays vary by plan and by place. The anchors above do not. Use them to spot errors in plan summaries and to keep your budget math honest while you shop.

• 2026 cost anchor: Part B standard premium; Amount: $202.90/month; What it means for your checklist: The base premium most people pay in 2026
• 2026 cost anchor: Part B deductible; Amount: $283; What it means for your checklist: What you pay first for Part B care in 2026
• 2026 cost anchor: Part D maximum standard deductible; Amount: $615; What it means for your checklist: The most a standard drug plan deductible can be in 2026
• 2026 cost anchor: Part D out-of-pocket cap; Amount: $2,100; What it means for your checklist: After this, covered drugs cost nothing more in 2026
• 2026 cost anchor: Covered insulin; Amount: $35/month per product; What it means for your checklist: A set cap for each covered insulin product
• 2026 cost anchor: ACIP adult vaccines; Amount: $0; What it means for your checklist: No cost for recommended adult vaccines under Part D

Check your doctors and home health agencies

A plan is only as good as the care you can reach with it. List your doctors, clinics, and hospital. List your home health agency, if you use one. Then check each plan's list for next year. Do not rely on last year's list. Ties change each year. Call the office and the plan to confirm. Ask the home health agency which plans it will work with next year. If your agency is out of a plan's network, you may face higher costs or a forced switch. Write down what you learn, with dates. If a key provider is missing, that plan may be a poor fit no matter how low its price looks.

Check your drugs, one by one

Make a full drug list. Include the name, the dose, and how often it is taken. Include inhalers, insulin, and creams, not just pills. Then run that list through each plan you are weighing. Check that each drug is covered. Check the tier, since the tier drives the copay. Check for rules such as prior approval or step therapy. Check the pharmacy too. A plan may cost more at your usual pharmacy than at one across town. Add up the full year cost, not just the first month. The cap can help heavy drug users, but only for covered drugs, so a drug that is not covered does not count toward it.

Check help for low incomes

Many people qualify for help and never claim it. Medicare Savings Programs can help with premiums and other costs. Extra Help can lower drug costs. The rules use income and savings, and many people are closer to the line than they think. Do not guess. Read our guide to checking Medicare Savings Programs and Extra Help and then ask your state or a local counselor to check for you. That check is free. If you qualify, it can change which plan fits best, because your costs drop in ways a plan brochure will not show. Put this check early in your season, not in the last week.

Compare total cost, not just premium

A low premium can hide high costs later. Add the premium to the costs you expect from care and drugs. Think about copays for visits, coinsurance for equipment, and drug costs across the whole year. Think about the worst case too. What would you pay if there were a hospital stay or a long home health episode? A plan that costs a bit more each month may cost far less in a hard year. Use the costs hub to keep your math in one place. Write each plan's total on one page. One page, side by side, is easier to judge than a stack of brochures.

Read the notices you already got

Your current plan must tell you what will change next year. Read that notice with care. Look for changes to your drugs, your providers, and your copays. Look for changes to extra benefits you use, such as rides or meals after a hospital stay. If the notice says a drug will move to a higher tier, price that change now. If it says your home health agency will leave the network, start your search now. Many people stay in a plan by default. Default is a choice too, and it can be the costliest one. Mark any change that hurts on your checklist so it stays in view while you compare.

Learn how to read a bill against a notice

Open Enrollment is also a good time to clean up old bills. If home health care happened this year, compare what you were billed with what Medicare said you owe. Our guide on comparing a Medicare Summary Notice with a home health bill shows the match, line by line. Errors do happen. A wrong bill paid without a check can also skew your sense of what care costs, which skews your plan choice. Set aside one hour for this task. It often pays for itself. Keep copies of what you find with your checklist notes.

Watch for traps and pressure

This season draws scams. Be wary of cold calls that ask for your Medicare number. Be wary of ads that promise large cash-back offers or free gifts. Be wary of anyone who rushes you to switch on the spot. Real deadlines matter, but you have weeks, not minutes. Use official plan tools and trusted local help. Your State Health Insurance Assistance Program gives free, unbiased advice. If a pitch sounds too good, stop and check it. The coverage hub can help you confirm what Medicare does and does not cover before you talk to any seller.

Make the change, then confirm it

If you switch, do it through a safe route, such as Medicare.gov or the plan itself. Note the date, the plan name, and any confirmation number. Then watch for your new plan card and welcome pack. Check that your pharmacy has the new plan on file before Jan 1. Tell your home health agency about the change early, so visits do not stall in the new year. Keep your old plan details until the new coverage is live and the first bill looks right. If you stay with your plan, write that down too, with the date you decided. A clear record ends doubt later.

What to do next

• [ ] List current care, equipment, and drugs on one page.
• [ ] Note the care changes you expect next year, including the unsure ones.
• [ ] Confirm your doctors, pharmacy, and home health agency for each plan you weigh.
• [ ] Check Medicare Savings Programs and Extra Help before you compare prices.
• [ ] Compare full-year total costs side by side, not just premiums.
• [ ] Decide before Dec 7, 2026, and keep your confirmation with your notes.