WASHINGTON — Millions of seniors face a critical decision during Medicare open enrollment, and many are making costly mistakes. The enrollment period—which runs through December 7—gives beneficiaries the chance to switch plans, but choosing the wrong coverage could mean thousands of dollars in unexpected costs.
According to research from Michigan Medicine, a significant portion of seniors don’t fully understand the plans available to them. The real question is: why does Medicare plan selection have to be so complicated?
What’s Happening With Medicare Plans
Medicare offers several options: Original Medicare (Part A and B), Medicare Advantage plans, and Medigap policies. Each has different costs, coverage levels, and provider networks. The problem? Most seniors don’t compare plans before enrolling.
Here’s the thing—many people stay with their current plan simply out of habit. They don’t realize that plan networks, drug coverage, and costs change every year. The Centers for Medicare and Medicaid Services reported that multiple payment provisions changed on October 1, 2025, affecting how Medicare covers services like telehealth.
According to the latest data, family health insurance premiums reached nearly $27,000 in 2025, reflecting a 6% increase from 2024. For Medicare beneficiaries specifically, Part B premiums rose to $202.90 monthly for 2026—an increase of $17.90 from the previous year.
Why This Matters for Your Coverage
Choosing the wrong plan directly impacts your wallet. If you pick a plan without your doctor on the network, you’ll pay out-of-pocket for every visit. If you select coverage that doesn’t include your medications, you’re footing the full bill until you hit your deductible.
“The decision to switch Medicare plans is one that deserves careful consideration,” said Dr. Jennifer Adams, Senior Healthcare Policy Advisor at the American Medical Association. “Beneficiaries should review their current coverage needs and compare plans based on their specific health situation.”
Medicare Advantage plans, which are growing in popularity, cover additional services like dental and vision. However, they typically require using in-network providers. Traditional Medicare offers more flexibility but may require additional Medigap coverage.
Additionally, CMS recently announced changes to star ratings for Medicare Advantage plans, affecting which plans receive bonus payments. This could influence plan availability and coverage options in your area.
What It Means for Your Health and Finances
The consequences of a poor plan choice extend beyond money. Seniors who can’t access their preferred providers may delay care or skip appointments entirely. This isn’t just an inconvenience—it impacts health outcomes.
During open enrollment, you should:
- Review your current medications and check if they’re covered under your prospective plan
- Verify your doctors and hospitals are in-network
- Compare out-of-pocket costs (premiums, deductibles, copayments)
- Check prescription drug coverage for any new medications
- Look at supplemental coverage options
Bottom line? Take time to review your options. The Medicare website (Medicare.gov) offers a plan comparison tool. You can also contact the State Health Insurance Assistance Program (SHIP) for free help. Making an informed decision now prevents headaches and expensive mistakes later.
Looking Ahead to 2026
As Medicare continues evolving, enrollment decisions become increasingly important. The 2026 changes include new payment rules, updated star ratings, and shifts in plan availability. Don’t assume your best plan today will remain your best plan next year.
Open enrollment ends December 7, so act now. Compare plans carefully, consider your health needs, and don’t let confusion leave you with inadequate coverage.
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