14 Tips for Getting Great Coverage

Tis the season… No, even though Christmas decorations are crowding out Halloween on store shelves, it is not quite time for the winter holidays. However, if you are 65 or over, it is the season of shopping! The Medicare Open Enrollment season is upon us and lasts from Oct. 15 to Dec. 7, 2025.

Now is the time to assess your current coverage and shop around for perhaps a better deal or a plan more suitable to your current health needs. Here are 14 tips for getting the best coverage and care from the Medicare Open Enrollment Period:

1. Know the Open Enrollment Rules

Medicare’s open enrollment is a time period every year when you can:

• Change from Medicare Parts A & B (Original Medicare) to a Part C (private Medicare Advantage) plan
• Change from Medicare Advantage back to Original Medicare
• Join, drop, or switch a Part D prescription drug plan
• Switch Medicare Advantage plans

You are never locked into your Medicare coverage for more than a year, and it is important to assess annually for better insurance at a lower cost.

2. Find Out How Your Existing Plan Has Changed

Not everyone knows this, but Medicare plans can – and do – change. So, the first step is to find out what is new with your existing coverage.

If there are changes, your plan should have sent you a “Plan Annual Notice of Change” (PNOC) last September. If you think you missed it, call your insurer and ask for the “annual notice of change.”

Pay particular attention to:

• The list of drugs that the plan will cover in the next year
• How much will those drugs cost
• What will the premium be in 2026
• What percentage of the plan will pay for different types of medical expenses

3. Find Out What Plans Your Preferred Doctors Will Be Accepting in 2026

You may want to call your doctors’ offices and ask to speak with the billing department. They should be able to tell you which plans they will be accepting in 2026. If they are dropping your existing plan, then you will want to see if any of the other plans are affordable for you.

4. Assess If Your Existing Plan Is Still a Good Match for Your Health Needs

Once you know what your existing Medicare Supplemental plan will cover in 2026, you should compare how well that matches your current and anticipated needs.

Will your existing plan still cover the medications you take? Has your health changed, and do you now have different needs?

5. Understand New Drug Plans (and Impact on Other Coverage)

For the prescription-drug side (Part D), while some premiums are expected to hold steady, there are structural changes that could lead to higher cost burdens for certain beneficiaries, such as changes to the out-of-pocket cap increasing to $2,100 from $2,000.

Again, be sure to look carefully at any changes to your current coverage.

6. Compare Your Existing Plan to Alternatives

Even if your existing plan works well for you, you should still shop around to see if there is a more cost-effective option.

You can contact your State Health Insurance Assistance Program (SHIP). SHIP (sometimes called by another name) provides free counseling to any Medicare recipient to help people choose a Medicare plan.

You can contact Medicare at 1-800-MEDICARE or Medicare.gov.  They have a Medicare plan comparison tool that may be helpful.

The Boldin Retirement Planner also enables you to estimate your lifetime medical costs for different coverage types, health conditions and premium levels.

Want human help with Open Enrollment questions?

Companies like Chapter and CoverRight® represent a wide range of insurers and will:

• Answer questions you have about coverage
• Help you compare your options
• Ensure your doctors and prescriptions are covered

They are commission-neutral, and it is free to work with them. Learn more below.

7. Beware of Medicare Scams and Don’t Believe All the Ads You’ll See

It is illegal for any licensed Medicare agent to make unsolicited contact with you. So, if you get a call, text, or voicemail from someone offering Medicare services, it is a scam.

Do not give out any personal information.

Also, be wary of the barrage of advertising you will likely see during this period.

8. Check Out Ratings on Plans

Once you have identified a plan or plans that may be a good fit for your particular health needs, you can look up how well those plans rate.

Medicare.gov lets you research plan quality and performance ratings.

U.S. News and World Report is also a reliable source. They evaluate all insurance companies. See their Best Medicare Advantage Plans and best plans by state.

9. Cut Your Prescription Costs

Even with supplemental coverage, prescription co-pays can add up. To save money, discuss your concerns with your doctor. Ask if they will prescribe a less expensive alternative or a generic.

Whatever your doctor prescribes, shop around to fill your prescription. Filling the same prescription at Costco versus CVS could save a lot. Ordering a 90-day supply online may save you even more.

10. Use a Health Savings Account (HSA)

If you’re still working and are eligible to contribute to an HSA, take advantage of it. Your contributions are made pre-tax, the money in your account grows tax-free, and you can withdraw funds from the account at any time tax-free, as long as the money is used for qualified medical expenses.

Learn more about HSAs: What they are and why they are a compelling savings option.

11. Be Proactive to Stay Healthy

If you are in good health, you’ll spend less on retirement health care costs.

Medicare offers a wide range of immunizations, preventive screenings and well-being programs for free.

12. Make Sure Out-of-Pocket Medical Costs Are Factored into Your Overall Retirement Financial Plan

Out-of-pocket medical costs are one of the three biggest expenditures for most retirees. Studies have shown that the total out-of-pocket Medicare costs are higher than the total Social Security income for the average retiree. In other words, Social Security income does not even cover what most retirees will have to spend on their health.

So, it is important to make sure that your retirement finances are prepared for this major expense.

The Boldin Retirement Planner is an award-winning tool that can help you prepare.  This easy-to-use software offers very detailed and sophisticated calculations and includes retirement health care costs.

13. Get Human Help with Your Decisions

Finding the right coverage isn’t easy. And, most of the help you’ll find comes from brokers tied to only a small handful of insurers. Your skepticism is justified. You deserve clear, unbiased guidance that shows you all your options.

To help you make confident healthcare decisions, Boldin has partnered with CoverRight® and Chapter. Both are independent agents, giving you access to a wide range of insurers—not just one. Even better, they’re commission-neutral, meaning their experts earn the same no matter which plan you choose.

Their goal is to help you find the coverage that fits you best.

Boldin’s Medicare partners: Help for your coverage decisions

The Boldin team researched and assessed both CoverRight® and Chapter and believe that they both offer a great service that is aligned with your needs. These companies are independent agents representing a range of insurers. Additionally, we receive compensation for these links.

CoverRight®: Click here to book an appointment or call 866 595 3191 to talk to a licensed advisor.

Chapter: Compare plans online or call 212 461 4182 to talk with a licensed advisor.

14. Know About Your Disenrollment Period

From January 1 to March 31, 2026 you can switch Medicare Advantage plans or move back to Original Medicare if you change your mind after enrollment.