Medicare Open Enrollment 2026 is approaching, and West Virginia residents should begin preparing before October 15. The Annual Enrollment Period runs from October 15 through December 7. During this window, people with Medicare can review their current coverage and, when appropriate, change Medicare Advantage or Medicare Part D prescription drug plans for coverage beginning January 1, 2027.
Your current plan may still be a good fit—but plans can change their premiums, copays, formularies, provider networks, pharmacies, and extra benefits from one year to the next. A careful annual review can help you avoid surprises.
1. Read your Annual Notice of Change
If you are enrolled in a Medicare Advantage or Medicare drug plan, your plan sends an Annual Notice of Change (ANOC) each fall. Medicare says this notice explains changes in coverage, costs, provider networks, service areas, and other plan details that will take effect in January.
Do not assume next year’s benefits will be identical to this year’s. Compare the ANOC with how you actually used your coverage. If you do not receive the document in September, contact your plan.
2. Confirm that your doctors and hospitals remain in-network
Provider networks can change. Before enrolling or staying in a Medicare Advantage plan, confirm that your primary doctor, specialists, preferred hospital, and other important providers will participate in the plan during 2027.
Use the plan’s provider directory, but consider calling both the provider and the plan for confirmation. Ask about the exact plan name—not only the insurance company—because one carrier may offer several plans with different networks.
3. Review every prescription and preferred pharmacy
Prescription coverage deserves its own review. Make an updated list of your medications, including the exact drug name, dosage, quantity, and frequency. Then check:
- Whether each medication is on the plan’s formulary
- Which coverage tier applies
- Whether prior authorization, step therapy, or quantity limits apply
- Whether your pharmacy is preferred, standard, or out-of-network
- Whether mail-order pricing is different
Medicare’s Plan Compare tool can estimate costs based on your prescriptions and preferred pharmacies. Remember that estimates are not guarantees and formularies can change under applicable Medicare rules.
4. Compare total yearly cost—not only the monthly premium
A low or $0 plan premium does not mean all care is free. Look at the entire potential cost of coverage, including:
- Monthly premium
- Medical and drug deductibles
- Primary-care and specialist copays
- Hospital and outpatient cost sharing
- Prescription costs
- The plan’s annual medical out-of-pocket maximum
The best value depends on your health needs, prescriptions, providers, finances, and preferences. No plan is best for everyone.
5. Review benefits you actually expect to use
Some Medicare Advantage plans may include additional benefits such as dental, vision, hearing, transportation, fitness programs, or certain over-the-counter allowances. Availability and details vary by plan and service area.
Review the limits, network requirements, authorization rules, and eligible services. An advertised benefit only has value if it is accessible and useful to you.
6. Understand the choice between Original Medicare and Medicare Advantage
Open Enrollment is also a good time to reconsider how you receive Medicare coverage. Original Medicare and Medicare Advantage work differently.
Original Medicare generally offers broad provider access nationwide for participating providers, while Medicare Advantage plans often use local provider networks and may require prior authorization for certain services. Medicare Advantage plans usually include Part D drug coverage and may offer extra benefits. Original Medicare does not include a yearly out-of-pocket maximum unless you have supplemental coverage.
If you have Medicare Supplement Insurance (Medigap), do not cancel it casually. Depending on your circumstances and West Virginia rules, you may not be able to purchase the same policy again later without medical underwriting. Get reliable guidance before making that change.
7. Compare carefully and protect your personal information
Medicare Open Enrollment brings increased advertising, phone calls, and mail. Be cautious with unsolicited contacts. Do not provide your Medicare number, Social Security number, banking information, or health information to an unknown caller.
Official Medicare resources include Medicare Plan Compare, the Medicare & You handbook, and 1-800-MEDICARE (1-800-633-4227). You may also obtain free counseling through the State Health Insurance Assistance Program.
When should West Virginia residents start reviewing coverage?
Start gathering information in September when Annual Notices of Change arrive. Update your medication and provider lists before October 15. When 2027 plan information becomes available, compare the plans offered in your West Virginia county and complete any desired enrollment change by December 7.
Free Medicare guidance from Songer Insurance
Songer Insurance has served West Virginia families for generations. We provide free, no-pressure help reviewing Medicare Advantage, Medicare Supplement, and Part D options from the insurers we represent. We can help you compare costs, provider access, prescriptions, and benefits in plain language.
Call 304-252-2158 or contact Songer Insurance to schedule a Medicare review before the enrollment rush.
Important Medicare disclaimer: We do not offer every plan available in your area. Currently, we represent organizations that offer a majority of the plans available in this area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (1-800-633-4227) to get information on all of your options.
This article is for general educational purposes and does not guarantee plan availability, benefits, costs, eligibility, or savings. Plan details vary by carrier, county, contract, and year.
Official Medicare resources
- Medicare.gov: Plan Annual Notice of Change
- Medicare.gov: Compare health and drug plans
- Medicare & You handbook