What to Know: Medicare Open Enrollment

October 14, 2025

Tomorrow marks open enrollment for the nearly 3 million Pennsylvanians with Medicare coverage.

And during a period of significant change, it’s important that everyone 65 and older reviews their plan options for next year.

Here’s what you need to know:

• Deadline:  Open enrollment is from October 15 through December 7. Enrollment is effective for January 1, 2026.
• Evaluate your coverage:  Now is the time for people with traditional Medicare, Medicare Advantage, and Medicare drug plans to evaluate their coverage and make adjustments where needed.
  • With significant plan changes expected this year, beneficiaries should review the options available to identify the plans that work the best for them.
  • Review of plans should include total costs, as well as the provider network available for care.
• By the numbers:  About 47 percent of Pennsylvania beneficiaries are enrolled in traditional Medicare, and 53 percent have Medicare Advantage and other health plans, which mirrors the national average.
• New this year:  Medicare Part D drug coverage caps yearly out-of-pocket costs at $2,100 for 2026.
• Quotable:  “If you haven’t reviewed your plan in recent years, now may be the time to check in,” Susan Neff, Pennsylvania Medicare Education and Decision Insight director (PA MEDI), said in a statement. “PA MEDI can help you compare all aspects of Medicare Advantage and Prescription Drug plans by looking at overall costs, provider networks, supplemental benefits, prior authorization requirements, and drug formularies.”

The Pennsylvania Department of Aging offers free, objective health benefits counseling through PA MEDI and Pennsylvania’s 52 Area Agencies on Aging or by calling the PA MEDI Helpline at 1-800-783-7067.

Additional information about open enrollment is available online.