Medicare Open Enrollment 101: What Seniors and Families Should Know
Medicare Open Enrollment is a time each year to review your healthcare coverage and make sure it still meets your needs. From Thursday, October 15 through Monday, December 7, those enrolled in Medicare can review their current coverage and make changes for the year ahead. Any changes made during Open Enrollment take effect January 1, 2027.
For older adults and their families, this can be a helpful time to think beyond insurance coverage and consider the kind of care and support that can help you live well as you age. That may include exploring care options like the Program of All-Inclusive Care for the Elderly (PACE), which provides comprehensive healthcare and support services designed to help eligible participants remain living safely in their home.
Whether you’re already enrolled in PACE, or simply exploring your options, Open Enrollment is a good opportunity to learn more and make informed decisions about your care.
Here’s what you need to know.
What is Medicare Open Enrollment?
Medicare Open Enrollment, also known as the Annual Enrollment Period, is an annual opportunity to review and make adjustments to your healthcare coverage. Plans can change from year to year, including costs, benefits, covered services, and provider networks. Taking the time to review your coverage can help you plan ahead and assess whether your current healthcare arrangement continues to meet your needs as you age.
For people enrolled in or considering PACE, it is important to understand how PACE works in conjunction with insurance. CEI is available to walk you through coverage options, including potential no-cost, partially funded, or self-pay plans.
What Does Open Enrollment Mean If I’m Already Enrolled in PACE?
If you are already enrolled in PACE, you do not need to select a separate Medicare Advantage or Medicare Part D prescription drug plan during Open Enrollment. PACE coordinates healthcare and support services through a comprehensive care team tailored to your specific needs. For participants with Medicare, PACE also includes Medicare Part D prescription drug coverage.
If you have questions about your Medicare coverage, prescription drug coverage, or PACE enrollment, a CEI enrollment specialist can help you understand how your coverage works and what options may be available.
What If I Already Have Medicare Advantage or Part D?
If you currently have a Medicare Advantage or Medicare Part D plan and are considering PACE, you do not have to wait for Medicare Open Enrollment to explore your options. Enrolling in PACE qualifies you for a Special Enrollment Period (SEP), which allows you to leave your Medicare Advantage or part D plan outside of the annual Open Enrollment Period. Once you enroll in PACE, all Medicare benefits are coordinated for you through your PACE program.
PACE is an all-inclusive care program that coordinates your Medicare benefits, healthcare, and specific support services through one cohesive care team. It is designed for adults aged 55 and older who meet eligibility requirements, need nursing-home-level care, and want to safely continue living in the community with PACE support.
Because PACE provides comprehensive care and coordinates Medicare benefits, you don’t need to be enrolled in PACE and a separate Medicare Advantage plan at the same time. Once you enroll in PACE, all your health needs are coordinated through your PACE care team.
Have Questions About Medicare or PACE?
Medicare and healthcare options can feel complicated. Center for Elders’ Independence is here to help. Whether you are already a CEI PACE participant, caring for a loved one, or exploring PACE for the first time, our specialists will answer your questions and guide you through next steps. Call us today at (844) 319-1150 or visit our PACE page to learn more.
