The thick stack of Medicare paperwork that shows up each fall can feel like the starting gun for comparing next year’s coverage, but some of the most useful preparation can happen before the envelopes arrive. Medicare plans generally send their Annual Notice of Change and Evidence of Coverage documents in September, outlining changes that will take effect in January. That gives beneficiaries a valuable window to organize their finances, prescriptions, and recent health care spending before Medicare Open Enrollment begins October 15.
Think of August and early September as the preparation period: you aren’t choosing next year’s plan yet, but you can organize the numbers you’ll need to judge whether your current coverage is still a good financial fit. Doing a little homework now can make it much easier to spot whether a higher premium, different drug tier, or changing copayment could actually affect your household budget. Instead of waiting until December to make a rushed decision, consider tackling these financial tasks while your current year’s costs are still fresh. Here are eight money moves you should consider making before you get next year’s Medicare paperwork.
1. Add Up What Medicare Is Actually Costing You
Start by calculating what you currently spend on Medicare rather than looking only at your plan’s advertised monthly premium. Include Part B premiums, Medicare Advantage or Part D premiums, deductibles, prescription copays, specialist visits, dental expenses, and other recurring health costs you pay yourself. If premiums are automatically deducted from Social Security, check a recent benefit statement so that expense does not disappear from your mental budget. Most beneficiaries who receive Social Security benefits have their Part B premium automatically deducted from their benefit payment.
For example, someone paying a $0 Medicare Advantage premium may still spend thousands during the year on copays, prescriptions, dental care, and other expenses. Conversely, someone paying higher monthly premiums may have much more predictable out-of-pocket spending.
2. Build an Updated Prescription List Before Comparing Plans
Prescription costs can change substantially depending on the plan, pharmacy, formulary placement, and whether a medication is subject to a deductible or coinsurance. Medicare says actual Part D costs depend partly on the medicines you take, whether they are covered by the plan, and which pharmacy you use. Before fall, create a simple list showing every prescription, dosage, frequency, preferred pharmacy, and approximate amount you currently pay.
That list becomes especially useful when Medicare Open Enrollment arrives because you can compare the cost of your actual medications rather than choosing a drug plan based primarily on its premium. It is also worth asking your doctor whether any medication is likely to change before January, since a new prescription can alter which plan offers the better overall value.
3. Check Whether Your Income Has Changed Enough to Seek Assistance
A retirement, death of a spouse, reduction in work hours, or other income change can make programs worth checking even if you did not qualify in the past. In 2026, Medicare lists Extra Help income limits of $23,940 for an individual and $32,460 for a married couple, along with resource limits of $18,090 and $36,100, respectively. Extra Help can reduce Part D premiums, deductibles, coinsurance, and other prescription costs for qualifying beneficiaries.
Medicare Savings Programs may also help eligible people pay Part B premiums and, depending on the program, other Medicare expenses, with states sometimes applying rules that are more generous than the federal limits shown by Medicare. Checking eligibility before Medicare Open Enrollment gives you time to understand what assistance might change the true cost of your coverage options.
Do not stop with Extra Help when checking whether a lower income could reduce Medicare expenses. Medicare Savings Programs, including QMB, SLMB, and QI, can help qualifying beneficiaries with Part B premiums and, depending on the program, other Medicare costs. Federal income and resource guidelines apply, but some states use higher limits or different rules for counting income and resources. That makes it worth applying or checking with your state even if your finances appear slightly above a published federal figure.
4. Review This Year’s Medical Spending for Patterns
Bank and credit card statements can reveal health care spending patterns that are easy to forget when you are staring at a plan comparison screen months later. Look back at what you paid for specialists, urgent care, outpatient procedures, physical therapy, medical equipment, prescriptions, dental work, and other recurring services. Circle the three categories that cost you the most this year. Those expenses should receive extra attention when comparing 2027 coverage.
For example, someone who began seeing a cardiologist every three months this year may need to give specialist copays and network participation much more weight when comparing plans for next year. Medicare Advantage plans can have different deductibles, coinsurance, copayments, and annual out-of-pocket limits, so the lowest premium is not automatically the least expensive choice.
5. Locate Your Creditable Drug Coverage Records
People who have prescription coverage through an employer, union, or another group health plan should locate their Notice of Creditable Coverage rather than assuming they will never need it. Medicare says these notices generally arrive in September and indicate whether the drug coverage is considered creditable, meaning it is expected to pay, on average, at least as much as standard Medicare drug coverage. Medicare specifically recommends keeping the notice because you may need it if you decide to enroll in a Medicare drug plan later.
Going 63 days or more without Medicare drug coverage or other creditable drug coverage can potentially trigger a Part D late-enrollment penalty, and that penalty generally continues for as long as you have Part D. Don’t cancel employer, union, or retiree drug coverage simply because a Medicare plan appears cheaper. Take the time to learn how other coverage works with Medicare before making changes, because enrolling in Medicare drug coverage can sometimes affect employer or union health benefits.
6. Create a Budget Range for Next Year’s Health Care
Before Medicare Open Enrollment, decide what your household could comfortably absorb if health expenses rise next year. Rather than setting a target for premiums alone, consider your total potential spending on premiums, prescriptions, copayments, coinsurance, and deductibles. This exercise is particularly useful for retirees living primarily on Social Security, pensions, or withdrawals from retirement accounts because an unexpected $100 or $200 in monthly medical expenses can require adjustments elsewhere. Keep in mind that a plan with a higher monthly premium may sometimes produce lower overall costs for someone who frequently uses covered services, while a low-premium plan can still carry substantial cost-sharing.
Expected: What would healthcare cost during a normal year?
Uncomfortable: What level of healthcare spending would require cutting another budget category?
Maximum: What could the household realistically absorb during a bad medical year?
7. Make Your Own Checklist Before the September Mail Pile
Medicare plans generally send their Annual Notice of Change and Evidence of Coverage documents in September, while Medicare households also receive important information ahead of Open Enrollment. Before those documents arrive, create a one-page checklist containing your current premiums, prescriptions, preferred pharmacies, doctors and specialists, major healthcare expenses from this year, and the maximum amount your budget could reasonably handle next year.
When your Annual Notice of Change arrives, mark every premium, deductible, copayment, prescription, pharmacy, provider-network, or benefit change that could affect something on that list. This makes the document less abstract because you’re comparing the plan’s changes against the healthcare services and medications you actually use. By the time Medicare Open Enrollment begins October 15, you’ll have a much clearer idea of which issues require further comparison rather than trying to analyze an entire insurance plan from scratch.
8. Check Which Doctors and Providers You Would Not Want to Lose
Cost is only one part of choosing Medicare coverage, particularly for beneficiaries who regularly see specialists or use a preferred hospital system. Make a list now of the doctors, specialists, hospitals, pharmacies, and other providers that would be difficult or inconvenient to replace. Medicare Advantage plans can use provider networks, and following a plan’s network rules can affect what you pay for covered care. When next year’s plan information becomes available, verify important providers with both the plan and the provider rather than assuming participation will remain unchanged. Knowing which healthcare relationships matter most gives you another practical filter for comparing coverage once Open Enrollment begins.
A Little Preparation Now Can Make Medicare Decisions Easier
Medicare Open Enrollment does not have to begin with a confusing stack of paperwork and a rushed search for last year’s prescription costs. Organizing your medications, healthcare spending, preferred doctors, financial-assistance information, and budget before September gives you a personal reference point for evaluating the changes your plan sends you. When the Annual Notice of Change arrives, you can focus on the differences that actually affect your health and your wallet instead of trying to decipher every page at once. Medicare Open Enrollment runs from October 15 through December 7, but the work that leads to a better-informed coverage decision can start weeks before that window opens.
What is the first Medicare expense or coverage detail you’ll check before this year’s Open Enrollment mail arrives?
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