Medicare Part D Resources

Fall Open Enrollment runs every year from October 15 through December 7. Whatever changes you make take effect the following January 1. If you enroll in a new part D plan during this window, your old part D drug plan will terminate automatically 1/1 while your new Part D drug plan will begin 1/1. You should see a card 2-4 weeks after you submit enrollment request through either 1800 Medicare via phone or online at medicare.gov 

What am I actually allowed to do during this period? You can pick up a stand-alone Part D plan for the first time, move from one Part D plan to another, cancel drug coverage entirely, or move between Original Medicare and Medicare Advantage. Taking no action usually means your existing coverage rolls over — but rolling over isn’t the same as staying identical, which is exactly why a yearly check-in is worth doing. If you take no action your plan will auto renew at the new terms/plan design unless your Medicare Drug plan notifies you of its plan to not renew its contract for the upcoming year. In which case you need to proactively enroll in a new Part D drug plan to avoid a Part D late enrollment penalty.

Not at all. If your plan is still working for you, leave it alone. That said, premiums, deductibles, drug formularies, and pharmacy networks can all shift year to year, so a quick comparison is still a smart habit even for a plan you’re satisfied with. A change is recommended if your plan is no longer suitable or your plan is terminating its contract with Medicare for the upcoming plan year.

ANOC is short for Annual Notice of Change — a letter your Medicare Drug plan sends out each September detailing what’s different for the upcoming year, including premium changes, deductible changes, formulary updates, network shifts, and copay adjustments. It’s one of the best tools you have for deciding whether to stick with your plan or start comparing alternatives.

Yes — Part D out-of-pocket spending on covered drugs tops out at $2,100 for 2026, up from $2,000 the year before. Once you reach that number, covered prescriptions are free for the remainder of the year, and the old coverage gap (“donut hole”) no longer applies. The 2027 Drug cap is expected to be $2,400.

That’s what the Medicare Prescription Payment Plan (MPPP) is for — it lets you break your out-of-pocket Part D costs into monthly installments rather than paying it all at the pharmacy counter. You can opt in when enrolling during Open Enrollment or ask your plan about signing up at other times of year too.

Going 63 days or longer without Part D or other creditable drug coverage after your Initial Enrollment Period ends can trigger a late enrollment penalty once you do sign up. In 2026, that penalty equals 1% of the $38.99 national base premium for each full month you went uncovered, and it typically sticks with your premium for as long as you carry Part D coverage. Open Enrollment lets you close a coverage gap going forward, but it won’t erase a penalty you’ve already built up.

Yes — it’s called Extra Help (also known as the Part D Low-Income Subsidy), and it lowers premiums, deductibles, and copays for qualifying beneficiaries. 2026 income guidelines run around $1,995/month for an individual and $2,705/month for a couple, with asset limits near $17,220 and $34,360 respectively (these adjust annually, so verify current figures). Extra Help also cancels out any late enrollment penalty and opens up extra chances throughout the year — beyond just Fall Open Enrollment — to switch stand-alone Part D plans. Applications go through the Social Security Administration.

 It’s possible. Beneficiaries above certain income levels pay an added Income-Related Monthly Adjustment Amount (IRMAA) on top of the standard Part D premium. This is calculated using tax return data from two years prior, and the thresholds change annually, so it’s worth checking if your income situation has shifted. You may appeal IRMAA if you have experienced a recent Life Qualifying Event. Read more on IRMAA here.

Don’t count on it. Plans can adjust their formularies annually — adding or dropping drugs, reassigning tiers, or introducing new requirements like prior authorization or step therapy. That’s precisely why your ANOC letter and a fresh Medicare.gov comparison matter each year rather than assuming nothing has changed.

Absolutely. Certain actions now have to happen directly on Medicare.gov or through 1-800 Medicare but our team is still here with education, guided instructions, and support to help you get through your own review and enrollment with confidence.

Once Fall Open Enrollment closes, Part D changes are generally limited to those who qualify for a Special Enrollment Period — triggered by things like a move, loss of other coverage, newly qualifying for Extra Help or Medicaid, or entering or leaving a nursing facility. Without one of those qualifying events, you’d typically wait until the next Open Enrollment window to make a change.