Right now, 68 million Americans have a deadline coming up: the deadline to decide their Medicare health coverage for next year if they’re over age 65 or have major disabilities.
They must make those decisions by December 7, for coverage beginning January 1, 2026, which makes this time, known as Medicare Open Enrollment, a very important time.
And yet, University of Michigan research has shown that many people covered by Medicare don’t take key steps during Open Enrollment that could save them money, headaches and worry.
Based on that research, here are five tips for everyone who has Medicare – and the family members and friends who can help them with their choices.
Use the tools
The official Medicare website has a lot of easy-to-understand and straightforward tools to help anyone understand their Medicare coverage options, and explore the options open to them or their loved ones.
But only 33% of people with Medicare used the Internet at all to explore their options, according to a recent U-M study.
That’s even though the choices can be dizzying: many people have dozens of options. Nearly all people have more than 10 Medicare Advantage plans to choose from, as well as multiple Part D prescription drug and Medigap supplemental plans to choose from if they opt for traditional Medicare.
The Medicare Plan Compare site is the place to start, and you can start on the Your Medicare Options page.
It’s available even during the government shutdown, because the plan-navigation tools on it were built before the shutdown began.
Using the Plan Compare site, you can see which Medicare Advantage and Part D prescription drug plans serve your area, what services or drugs they cover, what they charge for monthly premiums and for copays and other costs when you get health care or fill a prescription, and what the plan’s overall star rating is.
If you have a Medicare Advantage plan now, using the Plan Compare tool will also show you if your current plan will still be available next year.
Some plans are ending or combining with others.
You can also enter your prescription drug names and doses to see what they will cost you on different Part D plans, and whether pharmacies near you are in-network.
This includes the Part D drug coverage in many Medicare Advantage plans, as well as standalone Part D plans for people who choose traditional Medicare.
U-M researchers showed that using the prescription drug tool to compare estimated costs could save people a lot of money.
They did the study before the annual cap on Medicare prescription costs took effect in 2025, but still feel it’s important for everyone with Medicare drug coverage to use the tool.
If you need help navigating the Plan Finder site, or signing up for an account that will help you get the most use out of it, don’t be afraid to ask a friend, family member or neighbor. Or use the independent help described in Tip 2, below.
“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 U-M’s center for Value Based Insurance Design.
Get independent help
Half of people with Medicare get their coverage through Medicare Advantage plans run by insurance companies.
And of the other half, who choose traditional Medicare, nearly half get Part D prescription drug plans and “Medigap” add-on plans from private insurance companies.
Those insurance companies send out a lot of mail and email at this time of year, trying to persuade people to choose their plans.
They make phone calls, pay for advertising and even hold events where participants get a free meal in exchange for listening to the sales pitch for that plan.
They do all this because they make money on enrollees who are healthier and don’t use their insurance a lot.
Then there are insurance brokers and agents – people who do one-on-one consultations, but are paid for every person they sign up for a particular company’s plan.
While all of this can inform your decision, these aren’t independent sources of information. However, there is an independent source: your State Health Insurance Assistance Program, or SHIP.
Each state has one, with paid staff and trained volunteers who don’t have a financial stake in which plan you choose.
“With the overwhelming number of plans and the vast amount of information available, it’s essential to remember that free help is available,” said Lianlian Lei, Ph.D., who has studied Medicare enrollment by older adults and is an assistant professor in the U-M Medical School’s Department of Psychiatry.
“Seeking independent, unbiased assistance is crucial to making the best choice,” she added.
Because SHIP programs don’t have the marketing dollars that insurance companies and brokers do, many people don’t know about them.
In fact, a recent U-M poll showed that 75% of older adults have never heard of SHIP, and another 21% have heard of it but haven’t used it.
Only 4% of older adults had used SHIP services, even though they’re available for free to anyone eligible for Medicare.
In Michigan, anyone can reach the state SHIP program by calling 1-800-803-7174 from 8 a.m. to 8 p.m., Monday through Friday.
You’ll speak with an agent who can schedule an appointment or provide a referral to a trained, certified counselor in their community.
Not only that, the staff at this help line, called MiOptions, can also help older adults and their caregivers find out what other assistance they might qualify for.
You may also find trained SHIP volunteers offering free in-person counseling sessions at your local public library or senior center; check the events listings to see if any are coming up and how to make an appointment.
Look at the total package, not just the monthly premiums
When choosing any insurance, a lot of people focus on the monthly premium, and not on the total package of coverage.
This is true for Medicare too.
When you use the Medicare Plan Compare tool, you can see monthly premiums for different Medicare Advantage plans side-by-side.
But you can also see things like co-pays and other costs, which can vary a lot depending on how much health care a person actually uses.
The Plan Compare tool does not allow you to compare Medicare Advantage to traditional Medicare plus any add-on plans you choose.
So, you’ll want to note these costs for traditional Medicare, and then explore the Part D prescription drug plans and Medigap plans available in your area.
And remember, even if a Medicare Advantage plan says it has a $0 premium, that’s just for the coverage it provides beyond Part B.
Unless the plan includes a Part B premium reduction, which most don’t, you will still need to pay a monthly premium of at least $185, or more if you have a higher income.
Sometimes a plan with a higher monthly premium has lower out-of-pocket costs due at the time of care, or a lower cap on total out-of-pocket costs that you could owe each year.
The National Council on Aging has a great guide to all of these kinds of costs.
When choosing a Part D prescription drug plan or a Medigap plan to go with traditional Medicare coverage, it’s also important to compare options, based on the medications you take or whether you travel a lot or live in a second location during part of the year.
But surprisingly, U-M research shows it isn’t cost but access to care providers, and dissatisfaction with quality of care, that drive most people to switch Medicare Advantage plans.
Access to care is also the biggest driver for people leaving Medicare Advantage to switch to traditional Medicare, the study found.
That’s why it’s important to look at the star ratings that Medicare Advantage and Part D prescription plans have earned from past members’ opinions of them.
It’s also important to look at the networks of hospitals, doctors and other providers that each Medicare Advantage plan will allow you to go to, or the restrictions on specific drug classes that Part D plans might impose.
This kind of information is only available on each plan’s website.
The same research team has also looked at Medicare’s “revolving door” and the patterns of switching to and from the different forms of Medicare.
One item they note: Most states do not require insurers to ensure that people have the right to purchase Medigap plans regardless of their health status, except for an initial period after they enroll in Medicare for the first time.
This can result in Medicare Advantage “lock-in” for individuals with costly care needs, meaning they are unable to obtain Medigap coverage to help offset high out-of-pocket costs in traditional Medicare.
So, if you have significant health issues and have been in a Medicare Advantage plan, but you are thinking of switching to traditional Medicare, it’s important to understand if you’ll be able to get an affordable Medigap plan to cover costs that traditional Medicare doesn’t cover.
If you have a low income, see if you’re eligible for extra assistance
For older adults and people with disabilities who have limited incomes, there are new programs and supports available for 2026, on top of the ones already in place in 2025.
Some of them are automatic, but some require you to apply for them.
You can get help understanding all of the options open to you by contacting the SHIP program for your state (see above).
But here are some major ones to be aware of:
- Medicaid and Medicare together: Certain people are what’s called “dually eligible” because they are old or disabled enough to qualify for Medicare, and have incomes low enough or disabilities serious enough to qualify for Medicaid.
Each state has its own rules for qualifying for Medicaid; visit this page to learn more and use this page to find your state’s Medicaid agency contact information.
If you do qualify for both Medicare and Medicaid, the Medicaid program may help pay some of your Medicare costs.
Your state’s Medicaid agency can tell you more.
Also, if you have Medicaid coverage, with or without Medicare, it’s important to know that you have to re-qualify every year; U-M research shows that many people don’t know this.
- Medicare Savings Programs: There are four different programs available to people with limited resources and incomes.
Visit this page to learn more; contact your state’s agency to learn how to enroll.
- Help with drug costs through the Extra Help program: This program for Part D drug programs gives people with limited incomes and assets coverage for their medications with no monthly premium, no deductibles and low costs for drugs they get at pharmacies. Some people get enrolled automatically, but others may apply.
- Help with drug costs through the Medicare Prescription Payment Program: This program, open to anyone who has Part D prescription drug coverage through Medicare, allows you to smooth out your prescription costs over the year, so you don’t get a “spike” that might not be affordable.
Learn more here. It’s important to note that this program is one that you have to enroll in yourself, through your Part D drug plan provider, and you need to renew it every year; you do not get enrolled automatically.
- PACE program: The Program of All-inclusive Care for the Elderly, or PACE, aims to support home-based living for adults age 55 and older who are eligible for both Medicare and Medicaid and who need nursing-home level care.
It covers the cost of services beyond what Medicare and Medicaid cover. Find out if it’s available in your area here.
- Special needs plans: These are special Medicare plans for people who are dually eligible for Medicare and Medicaid; people with certain major health conditions including cancer, heart failure, dementia, diabetes, disabling mental health conditions, stroke, and others; and people who need nursing-home-level care for any reason.
You can find out if there’s one serving your area, and whether you might qualify, using the Plan Compare tool or by contacting your state’s SHIP program.
Don’t assume you and your spouse or partner should have the same plan
If you are married or live with a partner, your instinct might be to enroll in the same plan as them for convenience.
But that’s not always the best choice.
Your health needs, and your spouse’s or partner’s needs, may be very different. One of you might be retired, the other working.
Or maybe you have different coverage related to your past employment or military service.
If one of you has dementia, for instance, there may be special plans and programs that could cover more services.
But U-M research showed that people with and without dementia make very similar Medicare Advantage choices, which may mean they aren’t examining all their options.
No matter what your health status, and your spouse or partner’s health status, it’s still important to make individual choices when it comes to Medicare Open Enrollment.
U-M research has shown, though, that many people with Medicare Advantage coverage are making changes to their coverage in sync with their spouse or partner.
The Medicare online tools don’t have a “couples” setting, so each person should go through the process by inputting their information.
You could seek SHIP counseling together, but you may have to make two appointments depending on the program in your area.
Bonus tip about Medicare enrollment
Even if you make a choice during Medicare Open Enrollment, you may not be stuck with that choice for all of 2026.
For instance, if you choose a Medicare Advantage plan, but then realize in early 2026 that it’s not right for you, you will have until March 31 to choose a different Medicare Advantage Plan or move to traditional Medicare.
And if you have a major change in your income, employment, address, or living situation during 2026, you may become eligible for a Special Enrollment Period that will allow you to change plans.
Written by Kara Gavin, Michigan Medicine.
