Medicare open enrollment closes December 7, and after that date most plan changes have to wait for the next window.
October's article covered the number that does not appear on the enrollment form, which is the income-related surcharge calculated from a tax return filed two years earlier. That remains the larger number for higher-income households and is still worth reading. This is the shorter companion: what actually has to be decided in the next three weeks.
Drug coverage is the change most worth checking, because plans change and prescriptions change. Formularies are revised annually, and a plan that covered a medication well this year may not next year. This is the comparison most people skip and the one most likely to produce a surprise in February.
A plan that worked last year is not automatically the right plan this year. Networks change, premiums change, and the out-of-pocket maximum is frequently where the real difference between two plans sits rather than in the monthly premium.
If income changed because of a life event, there is a separate process. A surcharge based on a two-year-old return can be appealed when a life-changing event has reduced income since then, using Form SSA-44. (Source: Social Security Administration, Form SSA-44, Medicare Income-Related Monthly Adjustment Amount, Life-Changing Event.) Retirement is one of the qualifying events, which matters for anyone who stopped working after the year being measured.
The 2026 decisions you make this month set the 2028 premium. The return being written right now is the one that determines it, which is why the enrollment conversation and the year-end income conversation belong in the same meeting rather than in two separate ones.
Three weeks is enough time to work through this properly, and it is worth starting before the holidays rather than after them.
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