Medicare Open Enrollment 2026 FAQ: Dates, Changes, and How We Can Help

Helpful info from your local pharmacy – Cannon Pharmacy Mooresville, Mooresville, North Carolina

When is Medicare Open Enrollment?

October 15 – December 7, 2025. Changes take effect on January 1, 2026.

This is your annual opportunity to review and change your Medicare coverage for 2026.

Who can use Open Enrollment?

• Anyone already enrolled in Medicare can take advantage of this period.

What changes can I make?

You can:

• Switch plans
• Join, switch, or drop a Part D (drug) plan
• Return to Original Medicare from a Medicare Advantage plan
• Confirm your doctors, pharmacies, and medications will be covered

What’s new for 2026?

• Prescription out-of-pocket cap: Projected around $2,100 for the year*
• Insulin: Still capped at $35/month
• Vaccines: ACIP-recommended adult vaccines remain $0 under Part D

* Cap finalized by CMS. 2025 cap is $2,000; 2026 is indexed and may vary slightly

Why should I review my plan every year?

Plans change annually. Your doctors or pharmacies may no longer be in-network, formularies can change, and costs can shift. Reviewing helps you avoid surprises and ensures your coverage still fits your needs.

What happens if I miss the deadline?

If you don’t make changes by December 7, your current plan will usually renew automatically. After that, you can switch only during the next Open Enrollment or unless you qualify for a Special Enrollment Period.

Can I get help paying for Medicare?

Yes! The programs below can lower your prescription costs:

• Extra Help (Low-Income Subsidy) for Part D drug costs
• Medicare Savings Programs to help pay Part A/B premiums and other costs (if eligible)
• Medicaid, if you qualify

What’s the difference between Medicare Advantage and Original Medicare?

• Original Medicare: Part A (hospital) + Part B (medical). Add a stand-alone Part D drug plan if needed. Note: Medigap (Supplement) plans are not part of Open Enrollment; you apply separately.
• Medicare Advantage (Part C): All-in-one private plan that often includes drug coverage and extras (vision/dental/hearing). Networks and authorizations may apply

We can help you understand which option fits your needs.

Can I keep my doctor?

It depends on your plan. Medicare Advantage plans have networks, so verify your providers are in-network. Original Medicare lets you see any provider who accepts Medicare.

Will my prescriptions be covered next year?

Drug plans update their formularies annually. We can help you check each medication and find a plan that fits your list.

What is the “donut hole”?

Beginning in 2025, the old coverage gap is effectively eliminated. In 2026, once you reach the annual out-of-pocket cap, you won’t owe anything more for covered prescriptions for the rest of the year.

How do I avoid late enrollment penalties?

Enroll in a Part D plan as soon as you’re eligible or maintain other creditable drug coverage. Delays can result in permanent penalties.

How do I compare plans?

• Use Medicare’s Plan Finder at Medicare.gov to compare costs and coverage.
• Check STAR ratings (1–5) for plan quality.
• Bring your medication list into Cannon Pharmacy Mooresville, and we’ll run plan comparisons for you.

Can Cannon Pharmacy Mooresville help?

Yes! We’re here to:

• Review your medication list and preferred pharmacy.
• Check provider networks and drug formularies.
• Explain plan options and out-of-pocket costs.
• Connect you with savings programs if you qualify.

Need help?

• Call 1-800-MEDICARE (633-4227)
• Visit Medicare.gov
• Contact your local SHIP (State Health Insurance Assistance Program) for free, unbiased counseling
• Ask the Cannon Pharmacy Mooresville team - we’re here to help

Contact us online here or visit us at Cannon Pharmacy Mooresville in Mooresville, North Carolina. We’re happy to help you make sense of Medicare Open Enrollment.