Last week’s column explained the key decisions you must make about Medicare – either when you initially enroll, or during the annual Open Enrollment period that runs from October 15 to December 7, 2025. Those decisions will impact the cost and coverage of your health insurance for all of 2026.

Today, I want to go into greater detail on the process of choosing and changing Advantage Plans, or returning to Original Medicare – all of which are allowed only during Open Enrollment now, or in the first quarter of next year. If you make a mistake during this period it can be expensive and significantly limit your access to care for the year ahead. Ignoring this opportunity and doing nothing because everything was “ok” in the current year can create real problems next year.

Original Medicare – Premium Changes
If you’re in Original Medicare plus a supplement, there’s little to do every year. Having Original Medicare means you have your choice of providers who accept Medicare (almost all do) and that your supplement will work to cover your expenses wherever you live. It’s the optimum, but expensive, choice.

The cost of Original Medicare goes up every year. For 2026, when the announcement is made in early November, it’s estimated the monthly premium will rise to $206.50, up from $185 in 2025, representing an 11.6% increase—the largest jump in several years. Sadly, the increase in Medicare Part B premiums will likely eat up the projected 2.7% COLA increase in recipients’ Social Security monthly benefit.

And, depending on your income, you could be subject to a higher monthly Part B premium — the IRMAA surcharge – which could add several hundred dollars a month to your cost. The specifics will be announced along with Part B premiums in coming weeks, and I’ll post a link here when it is announced.

The cost of your Supplement will also rise — likely between 7-9%. You can stick with your current supplement, unless you have service issues, since all will be raising prices. You can compare supplement costs at Medicare.gov. And if the costs rise too much, you could switch to a lower cost plan with lesser coverage for co-pays or other out-of-pocket costs, assuming you qualify based on health.

All those rising costs add up – a real squeeze for many seniors. And that is why so many – nearly half of Medicare beneficiaries — have chosen Advantage plans. They have lower out-of-pocket costs – for a reason!

Switching Between Advantage Plans
Over the past four years, I’ve written annual columns explaining the drawbacks of Advantage Plans – essentially managed care. In recent months, these delays and denials of services have become well publicized. Advantage plans work well while you’re healthy. But when you have an illness and seek a second opinion, or specialized testing, or a surgical referral you’re suddenly faced with the limitations of your plan’s network of providers and delays in approvals.

This year the problems are magnified, since many physicians and hospitals have dropped out of last year’s plans – fed up with the hassle of gaining permissions and low reimbursements.

That’s why it’s absolutely essential to review your Medicare Advantage plan NOW – because the current Open Enrollment period, along with the Advantage Open Enrollment period in the first quarter, are the only times Advantage participants can make a change – either switching to another Advantage Plan or back to Original Medicare.

Check the notice that your current plan has sent to you – not only about changes in price, but changes in participating physicians and hospitals. If your care provider is no longer in your plan, contact them immediately and ask what local Advantage plans they do participate in.

A good place to start your search is at Medicare.gov. There you can “search Advantage plans” and then use each plan’s provider directory to search for included physicians, specialties, or hospitals. It can be a tedious process – and even worse, you don’t know now which specialty provider you might need if you become ill during the year ahead!

There is free help available, paid for by sales commissions baked into the cost of the plans. Get advice from agents who sell Advantage plans in your state at eHealth.com and BoomerBenefits.com. You can also turn to your State Health Insurance Assistance Program through ShipHelp.org.

Switching Back to Original Medicare and a Supplement
Once you are ill and seeking your choice of care, many people want to switch back from an Advantage plan to Original Medicare. You can do that during Open Enrollment. BUT in most states you are no longer guaranteed acceptance into the most comprehensive supplement because of your pre-existing condition.

You may have to settle for less coverage of out-of-pocket expenses (more costs to you) in order to have the freedom of choice of providers that you get in Original Medicare.

Yes, it’s unfair and horrific that seniors must go through this process every year – making sure their coverage for next year is both affordable and comprehensive. But you can’t afford to ignore the process. And that’s The Savage Truth.
(Next week’s column will focus on Part D drug plans, which absolutely must be reviewed now.)