Seniors intently comparing Medicare plans on laptops ahead of the December 7 open enrollment deadline.
Seniors intently comparing Medicare plans on laptops ahead of the December 7 open enrollment deadline.
صورة مولدة بواسطة الذكاء الاصطناعي

Millions of Americans near Medicare open enrollment deadline

صورة مولدة بواسطة الذكاء الاصطناعي
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With the December 7 deadline approaching, about 68 million Americans covered by Medicare must decide on their health coverage for 2026. University of Michigan research finds that many do not use available comparison tools, potentially leading to higher costs and less suitable coverage. Experts urge beneficiaries to rely on official resources and independent counseling to navigate their options.

Medicare’s fall Open Enrollment period, which runs through December 7, allows people age 65 and older, as well as younger adults with qualifying disabilities, to review and change coverage for the coming year. Those who change plans by that date will generally have coverage effective January 1, 2026, according to guidance from the Centers for Medicare & Medicaid Services and recent University of Michigan outreach.

A recent University of Michigan study cited by Michigan Medicine reports that only about 33% of people with Medicare used the internet at all to explore their plan options, even though many beneficiaries face a dizzying array of choices, often including more than 10 Medicare Advantage plans plus multiple stand‑alone Part D prescription drug and Medigap supplemental policies.

The official Medicare Plan Compare tool on Medicare.gov allows users to compare premiums, copays, coverage of specific medications, provider networks and plan star ratings. Michigan Medicine notes that using this tool to compare total prescription drug costs can result in substantial savings over the course of a year. At the same time, major changes taking effect in 2026 — including a new annual cap of about $2,100 on out‑of‑pocket spending for covered Part D drugs and the option to spread drug costs over the year — give beneficiaries additional reasons to review their coverage annually.

Insurance companies and brokers heavily promote Medicare Advantage plans through mailings, phone calls, advertising and in‑person events, but these sources are typically tied to specific insurers. By contrast, each state’s State Health Insurance Assistance Program, or SHIP, offers free, unbiased counseling from trained staff and volunteers. According to the University of Michigan’s National Poll on Healthy Aging, 75% of older adults said they had never heard of SHIP, 21% had heard of it but never used it, and only 4% had actually received SHIP help.

In Michigan, residents can reach the state’s SHIP‑related counseling services through the MI Options call center by dialing 1‑800‑803‑7174 between 8 a.m. and 8 p.m., Monday through Friday, the Michigan Department of Health and Human Services reports. Callers can receive an appointment or a referral to a certified counselor in their community at no cost.

Experts at the University of Michigan emphasize that it is not enough to look only at monthly premiums when choosing a plan. Beneficiaries are encouraged to consider total anticipated out‑of‑pocket costs, including deductibles, coinsurance and copays, as well as whether their preferred doctors, hospitals and pharmacies are in network. U‑M research indicates that access to care and out‑of‑pocket spending are key reasons people change plans.

Low‑income beneficiaries may qualify for extra financial assistance, such as Medicare Savings Programs that help with Part A and Part B costs, the federal Extra Help program for prescription drugs, or coverage through both Medicare and Medicaid. These programs are administered by federal and state agencies and typically require beneficiaries to update or confirm their eligibility periodically.

Couples are also advised to compare plans separately, since they may have different health needs, medications and preferred providers. University of Michigan researchers note that many couples report making coordinated decisions, but the Medicare Plan Compare website evaluates each individual’s situation separately, and the best plan for one spouse may not be the best for the other.

For people enrolled in Medicare Advantage, federal rules provide additional flexibility early in the year. Under the Medicare Advantage Open Enrollment Period, beneficiaries who start 2026 in a Medicare Advantage plan generally have until March 31, 2026, to switch to another Medicare Advantage plan or return to traditional Medicare. People who experience certain life changes, such as moving or changes in other coverage, may also qualify for a Special Enrollment Period that allows them to change plans outside the standard windows.

“Given changing clinical circumstances and the fact that insurance plan costs and benefits are often modified from year to year, it is very important that people with Medicare coverage use the available tools during Open Enrollment to identify a plan that best meets their medical needs and fits their financial situation,” said A. Mark Fendrick, M.D., director of the University of Michigan Center for Value‑Based Insurance Design, in comments shared by Michigan Medicine.

“With the overwhelming number of plans and the vast amount of information available, it’s essential to remember that free help is available,” added Lianlian Lei, Ph.D., an assistant professor in the U‑M Medical School’s Department of Psychiatry who studies how older adults navigate Medicare. “Seeking independent, unbiased assistance is crucial to making the best choice.”

ما يقوله الناس

X discussions emphasize the nearing Medicare open enrollment deadline on December 7, urging beneficiaries to compare plans via official tools to avoid higher costs and unsuitable coverage. Sentiments include frustration with pervasive TV ads, warnings about scams, promotions of AI for plan selection, and reminders from officials and advocates to review options promptly.

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