SHIIP counselors ready to assist Iowans during Medicare Open Enrollment

Every fall, Medicare beneficiaries can review and change their Prescription Drug Plan or Medicare Advantage Plan during the Open Enrollment Period from October 15 to December 7. Iowans who miss the open enrollment deadline most likely will have to wait a full year before making changes to their plan. Changes to Medicare plans will be effective January 1, 2026. 

Medicare Prescription Drug Plan and Medicare Advantage Plan costs, benefits, covered prescriptions and provider networks can change each year. Following the 2025 cap on prescription drug copayments, and new price negotiations on 10 high-cost sole-source drugs starting in 2026, many plans are significantly adjusting their benefits and coverage options. This is a critical time to read all mail from your plan or provider and stay informed of possible changes.

Medicare beneficiaries receive an Annual Notice of Change (ANOC) each September from their Prescription Drug Plan or Medicare Advantage Plan. This is a summary of any changes in the plan that will take effect on January 1 of the next year (i.e. premium cost, coverage, copays, and service area).

Some beneficiaries will also receive notice that their plan may not continue next year, and they will need to find a new plan during the Open Enrollment Period.

If a Medicare beneficiary is happy with current coverage after reviewing plan changes and options for the year ahead, no action is necessary during Open Enrollment – they will automatically be re-enrolled for the following year, as long as their Part D or Medicare Advantage plan has not been cancelled. However, it is smart to always compare the current plan to other options available for the year ahead.

2026 plan details for the year ahead can be found at: Medicare.gov/plan-compare. Through the Medicare.gov Plan Finder, Medicare beneficiaries can see and compare plan options available in their zip code in 2026, even incorporating their specific prescriptions and pharmacies.

Local Medicare Help

The Iowa Insurance Division’s Senior Health Insurance Information Program (SHIIP) is available to offer free, unbiased and confidential assistance to Iowans in this process.  Volunteer counselors can help people understand their Medicare benefits by:

• Checking a client’s current Part D or Medicare Advantage plan to make sure drugs are covered at the lowest cost and with the least amount of restrictions
• Reviewing a client’s employer coverage and comparing it to other Medicare options
• Checking to see if clients are eligible for Part D “Extra Help”
• Providing education to help clients understand options if not currently on a drug plan

SHIIP counselors review all plans and do not promote any particular plan or company.  To help you compare plans during the open enrollment period, volunteer SHIIP counselors are available by appointment locally at WinnMed in Decorah by calling 563-387-3036.  In-person and telephone appointments will be offered to clients.

Karla Bakken, SHIIP coordinator at WinnMed, says, “I encourage seniors to schedule an appointment with a SHIIP counselor early this season and not wait.  Those who wait until the end of the enrollment period to start the process may miss the deadline.”  The deadline for changing plans is December 7, 2025.

For SHIIP support, call WinnMed at 563-387-3036.