Medicare Open Enrollment on Cape Cod: 15 October to 7 December

What can I change during Open Enrollment?

• Join, drop or switch a Medicare Advantage plan (the all-in-one private plans).
• Move from Original Medicare to an Advantage plan, or back again.
• Join, drop or switch a stand-alone drug plan (Part D) if you have Original Medicare.

Whatever you choose starts on 1 January. If you do nothing, most plans simply renew — with next year’s prices, drug list and network, which may not be this year’s.

If you are already in an Advantage plan and regret it, the Medicare Advantage Open Enrollment Period from 1 January to 31 March lets you switch to another Advantage plan once, or return to Original Medicare and add a drug plan.

What is different about choosing a plan on the Cape?

• Networks. Check that the plan includes the doctors you actually see, Cape Cod Healthcare, and any Boston hospital or specialist you travel to. A plan that looks cheaper can be expensive if your cardiologist is out of network.
• Pharmacies. Check your own pharmacy is “preferred” in the plan, including a delivering pharmacy if you have stopped driving.
• Part-year residents. If you spend winters elsewhere, ask how the plan covers routine care out of state. Many Advantage plans cover only emergencies outside their area.
• Massachusetts Medigap is different. Massachusetts has its own supplement plans (“Core” and “Supplement”) with different rules from most states. If you are thinking of leaving an Advantage plan for Original Medicare, ask SHINE how a supplement would work for you before you switch.

What will Medicare cost in 2026?

The figures in the table above are Medicare’s own for 2026. Plan premiums, copays and drug costs vary by plan, which is why the annual check matters. The $2,100 yearly cap on what you pay for covered drugs is new ground for many people with expensive prescriptions: ask SHINE whether spreading payments through the year (the Medicare Prescription Payment Plan) would help.

If money is tight, ask SHINE about the Medicare Savings Programs and Extra Help with drug costs. Many people who qualify never apply.

How do I get free, unbiased help?

SHINE (Serving the Health Insurance Needs of Everyone) counsellors are trained volunteers. They sell nothing and earn nothing from any plan. They will compare plans using your actual drugs and doctors. On the Cape most appointments are booked through your town’s Council on Aging, and November fills up, so call early.

Book through your Council on Aging:

Bring to the appointment

• Your red-white-and-blue Medicare card and your current plan card
• Every medicine, with the dose and how often — or the bottles themselves
• Your pharmacy, your doctors and any hospital you use, on or off Cape
• The “Annual Notice of Change” your plan mailed in late September

I’m helping a parent. What can I do from a distance?

• Ask your parent for the Annual Notice of Change and a list of their medicines — a photo of each label works.
• Book the SHINE appointment for them and join by phone if you can.
• Make sure they know that Medicare will not phone them. Scam calls peak during Open Enrollment.
• If they have trouble managing paperwork, see the papers every family needs — a health care proxy and power of attorney make everything easier.

What happened to Prescription Advantage?

Massachusetts’ own drug-cost programme, Prescription Advantage, stopped accepting new applicants after 11 September 2026. Existing members keep their coverage. If you were planning to apply, ask SHINE what else you may qualify for.

Mistakes families make

1. Letting a plan renew without checking whether your drugs are still covered, and at what tier.
2. Choosing on the premium alone. A $0-premium plan can cost more in copays and out-of-network bills.
3. Joining a plan from a television-ad phone call without checking the network includes your doctors.
4. Leaving an Advantage plan for Original Medicare without first asking how a Massachusetts supplement would work.
5. Missing 7 December. After that, most changes wait a year.