Medicare Open Enrollment runs from October 15 through December 7, 2026. The State of Delaware is reminding those 65 and older of tips for a successful enrollment in Medicare plans.
Enrolling in a Medicare Advantage Plan means that it becomes your primary coverage. Medicare will no longer pay for services. A new ID card will be sent from the new plan but store your Original Medicare card in a safe place. Medicare recipients are also reminded that when moving from an Original Medicare plan to a Medicare Advantage plan, be prepared to pay both a monthly Medicare Advantage premium and a monthly Medicare Part B premium.
Although many advertisements state that a Medicare Advantage plan gives you “more money in your Social Security check every month,” this is not an automatic benefit. In order to qualify, recipients must be eligible for the Medicare Savings program by having an income below Medicaid limits.
Check that any additional benefits, such as vision, dental, hearing, fitness or over-the-counter medications are accessible if offered. Many network providers of these services may be farther away than anticipated, including in neighboring states, so only factor them into your decision if you feel they are usable.
Medicare Advantage plans may have co-pays or cost-sharing that differ from Original Medicare, so keep in mind premiums may not be the only out-of-pocket costs you face.
It is also important to call your healthcare providers and facilities to be sure that the plan you are considering has a contract with them. Visiting a provider considered out-of-network could result in additional out-of-pocket expenses, service denial or referral requirements.
Another factor to consider is whether the plan is a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO). HMO plans require healthcare to be completed by a provider contracted with the plan’s network, otherwise the consumer will need a referral. PPO plans have both in-network and out of network providers and facilities, with consumer costs differing based on the network. HMO and PPO plans are not Medicare Supplement Plans and may have out-of-pocket costs each visit.
Not all Medicare Advantage plans offer prescription drug coverage (Part D), so confirm the plan you are considering offers that option.
Keep in mind that enrollment locks you into that plan for the full upcoming calendar year.
Be wary of unsolicited calls during Medicare Open Enrollment. Be sure you are speaking with a known, credible source. Commercials, cold calls and other contact may be scams or can provide deliberately misleading information about a plan.
When selecting 2027 coverage, the Medicare Prescription Payment Plan works with a beneficiary’s current drug coverage to help manage out-of-pocket Medicare Part D drug costs by spreading them across the calendar year. Anyone with a Medicare Advantage Plan or Medicare health plan with drug coverage can voluntarily use this payment option. If selected, you pay your premium each month and get a bill from the health or drug plan to pay for the prescription instead of paying at the pharmacy. There is no cost to participate.
In 2027, Part D enrollees out-of-pocket drug costs will be capped at $2,400. This amount will be indexed to rise each year at the rate o growth in per capita Part D costs. In addition, the 2027 negotiated prices for medications is available at Fact Sheet: Medicare Drug Price Negation Program June 2027.
For more information about Medicare Open Enrollment, call 1-800-366-9500 or 302-674-7364. You can also visit the Delaware Department of Insurance online.
