According to a recent survey conducted by NerdWallet, a significant 64% of Americans are concerned that the current administration might reduce Medicare benefits. For some, this fear might soon become a reality, with changes potentially taking effect as early as next year, accompanied by higher costs.

The Medicare Trustees have projected a notable increase in Medicare Part B premiums, expecting them to rise by $21.50, reaching a total of $206.50 next year. This anticipated hike is one of the most substantial in the history of Medicare. Additionally, Medicare Part D prescription drug plans could see premiums surge by up to $50, a considerable jump from the previous year’s government-imposed cap of $35. Compounding these challenges, several leading private insurers are either scaling back their Medicare offerings or completely withdrawing from the market due to financial losses.

Amidst these changes, consumers have a crucial opportunity to safeguard themselves against escalating costs, dwindling provider networks, and vanishing benefits during Medicare’s fall open enrollment period. This annual window, open from October 15 to December 7, allows individuals to add, drop, or switch their Medicare plans.

“This year’s open enrollment period is arguably the most significant in Medicare’s six-decade history,” says Melinda Caughill, co-founder of 65 Incorporated, a firm specializing in Medicare guidance. “It’s essential for everyone to scrutinize their plans.”

To assist you in navigating your choices this fall, here’s a Medicare open enrollment checklist to help evaluate your current plan and explore alternatives.

1. Read your Annual Notice of Change carefully

Medicare enrollees should have received an Annual Notice of Change (ANOC) in the mail in September detailing changes to their plan for the upcoming year. Note any changes to your plan’s:

• Premium.
• Deductible.
• Copays and coinsurance.
• Maximum out-of-pocket limit.
• Provider network and service area.
• Prescription drug coverage and pharmacy network.
• Medical benefits.
• Other benefits.

2. Confirm your prescription drugs are still covered and affordable

Carolyn McClanahan, a physician and certified financial planner (CFP), says the biggest mistake seniors can make is to not revisit their prescription drug coverage. “Too many people just let it coast, and their drugs may not be on the formulary or the cost has gone up a lot,” says McClanahan.

Don’t rely on your ANOC alone. Caughill urges consumers to visit their insurance company’s website and look up their medications on the plan’s new formulary, or list of covered drugs. While Medicare prescription drug plans come with a $2,100 cap on out-of-pocket costs in 2026, this cap only applies to covered drugs. If a drug you need isn’t on your plan’s formulary, it could easily wipe out your savings.

Even if your drugs are covered, they could be in a different cost-sharing tier, warns Caughill. For example, a drug that came with a $10 copay this year may switch to a 25% coinsurance next year. If the retail price of that drug is $1,000, your cost will jump from $10 to $250. “Plans that worked this year may not work for you next year at all,” says Caughill, so you might want to compare your coverage with other Medicare prescription drug plans.

3. Verify your doctors and hospitals are still in network if you’re on Medicare Advantage

“The wild card in Medicare Advantage is plan networks,” says Caughill, because they can change at any time. If your medical provider is suddenly dropped from your plan’s network, you’ll either have to find a new one or face high out-of-network costs. And with insurers pulling back on their offerings, the region(s) where your plan operates could be shrinking.

On top of that, preferred provider organization (PPO) plans, which give enrollees more freedom to see out-of-network providers, are being shut down by some insurers. Call your primary care doctor and any specialists or hospitals you plan to visit and confirm they will still be in your plan’s network next year.

4. Look past the perks and prioritize long-term financial security

Rising costs may tempt seniors to enroll in Medicare Advantage plans that flaunt low premiums and extra perks like dental allowances and gym memberships. But McClanahan warns against trying to save money this way.

The premiums are often low because the plan limits who you can see and where you can go to get care. Your doctor could drop your plan at any time, and you might not be covered for certain services if you can’t get prior approval. “You can shoot yourself in the foot down the road when you get sick and need better care,” she says.

When it comes to the extras offered by Medicare Advantage plans, Caughill doesn’t recommend letting them be a deciding factor either. “They’re like sprinkles,” she says. “The reason any of us have health insurance is for cancers, strokes, heart attacks, chronic conditions, car accidents.” Make sure you have adequate coverage for those things before “adding on the sprinkles,” and prioritize keeping your deductibles and maximum out-of-pocket costs low.

5. When major changes hit, consider returning to Original Medicare

If you’re on Medicare Advantage and your plan is discontinued or leaves your area, you may want to think about switching to Original Medicare and getting a Medicare Supplement Insurance, or Medigap, plan.

Medigap plans help cover out-of-pocket costs, which are unlimited on Original Medicare. “You should never be on traditional Medicare without having a Medigap plan,” says McClanahan, because it exposes you to high financial risk.

If you missed signing up for Medigap when you joined Medicare, you’re often subject to medical underwriting, which can make it hard to get an affordable policy. But certain significant changes, like if your Medicare Advantage plan shuts down or no longer operates in your area, temporarily give you “guaranteed issue rights.” This means Medigap insurers can’t deny you or charge you more because of your health.

Once you’ve reviewed your plan changes, you can use the Medicare plan finder tool on Medicare.gov to compare options and decide if it makes financial sense to change Medicare plans. If you end up deciding to switch, enroll in your new plan by the Dec. 7 deadline.