Patient Advocate Foundation shares best tips for Medicare open enrollment

With the annual Open Enrollment period for Medicare fast approaching on October 7, the expert patient advocates at the Patient Advocate Foundation (PAF) have released their top tips for patients who are either new to Medicare or who are seeking a better plan for 2027. 

First, says Amber McCracken, senior director of programs and outreach, understand that the open enrollment period is for everyone, not just new enrollees. “Even if you’re happy with your current coverage, it’s prudent to assume that your plan will change in the next year, whether it’s a Medicare Advantage plan, a Part D plan, or supplemental coverage.”  

To help consumers make the best choice for their budget and healthcare needs, Patient Advocate Foundation has updated and expanded its Open Enrollment educational resources for Medicare, as well as for individuals with marketplace health insurance coverage or employer-sponsored health coverage, allowing anyone to find the practical tips and assistance they need. 

“It can be hard to get started, which is why it’s important to plan ahead,” says McCracken. “Give yourself time to organize your paperwork and to write down all your coverage needs before you choose a plan. If you do it at the last minute, you may miss something or even be penalized. This is particularly important for seniors with multiple or chronic conditions, who need regular access to care and whose costs could escalate.” 

Other tips include:

1. Learn the lingo—and how it affects your bottom line. Start with the basics: premiums, deductibles and copays all incur out-of-pocket costs in different ways. The more you understand, the better you can choose the best plan for your budget. PAF’s Guide to Understanding Your Insurance Documents can help.  
2. Know the different Medicare plans. If you’re on a traditional Medicare plan, that means you have Medicare Part A (hospital coverage) and Medicare Part B (medical coverage). Your prescriptions are covered under a Part D plan. Supplemental plans—also called Medigap—may cover out-of-pocket costs or offer other benefits. Some consumers opt out of traditional Medicare and choose a Medicare Advantage plan, which functions more like an employer-sponsored plan. Learn more about the different Medicare plan options here.
3. Don’t forget your medications. While prescription coverage may come with your Medicare Advantage plan, enrollees in traditional Medicare will need to purchase a Part D plan to cover their prescriptions. When choosing a plan, write down a list of all your current prescriptions and make sure they’re covered in the formulary of the plan you choose. Check, too, for prior authorization requirements and other administrative restrictions. 
4. Know your limits. In 2027, the annual out-of-pocket limit for covered Part D prescription drugs is $2,400, compared to $2,100 in 2026. There is also a $35 cap on covered insulin products. Once you reach the limit, you will not pay additional out-of-pocket costs for covered Part D medications for the rest of the year. Consumers can find more information about the Part D cap here. Learn more here. 
5. Know your deadlines. Patients often don’t realize that they will face a penalty and be unable to enroll in Part B until the next open enrollment period if they miss the current one. That’s not the only enrollment deadline that comes with a penalty: if you don’t have creditable prescription coverage, you’ll face a late enrollment penalty that will be added onto your Part D premium for as long as you have Part D. Finally, if you’re interested in a supplementary, or Medigap plan, but delay enrolling, companies can deny your application or charge higher premiums.  

With Medicare Open Enrollment beginning on October 7, patient advocates urge Medicare beneficiaries to get started today. “The wrong plan can add to your costs, pile on an administrative burden and ultimately keep you from the care you need,” said McCracken. “A careful selection will set you up properly for the year ahead.” 

To learn more about Medicare and other insurance-related topics, including open enrollment, consumers can visit Patient Advocate Foundation’s Guide to Open Enrollment. 

The new resources include: 

• Open Enrollment: What You Need to Know  
• Medicare: What You Need to Know During Open Enrollment  
• Marketplace: What You Need to Know During Open Enrollment 
• Understanding the Medicare Part D Cap 
• Understanding the Medicare Prescription Payment Plan  
• Extra Help for People on Medicare 

About Patient Advocate Foundation 

Patient Advocate Foundation is the nation’s most comprehensive nonprofit dedicated to helping patients navigate, access, and afford their care while improving the healthcare system for all. We provide financial assistance to help patients afford treatment and cost of living needs, personalized case management to navigate complex healthcare and social needs challenges, and a wide array of resources to empower people to take charge of their health.  

Since our founding in 1996—and joining forces with the PAN Foundation in 2026—we have helped more than 3.8 million people access and navigate care, granted over $7 billion in financial assistance, provided personalized case management support to over 350,000 patients, and elevated the patient’s voice to drive improvements in the healthcare system.  

Learn more at Uniting.PatientAdvocate.org.