Medicare Open Enrollment Is Coming: A Texas Family's Prep Checklist

If you help an aging parent or loved one manage healthcare, October is a good time to sit down together and review their Medicare coverage. A plan that worked well this year may have different premiums, provider networks, pharmacy rules, or prescription costs next year.

For Texas families, Medicare Open Enrollment runs from October 15 through December 7, 2026. Changes made during this period generally take effect on January 1, 2027, as long as the plan receives the enrollment request by December 7.

This checklist can help you prepare before comparing Medicare Advantage and Part D prescription drug plans.

Important: This article provides general information and is not insurance, financial, or medical advice. Medicare rules and plan details can change. For personalized guidance, visit Medicare.gov or contact a free, unbiased Texas SHIP counselor through the Medicare local assistance directory. Texas families can also contact the Texas Health Information Counseling and Advocacy Program at 1-800-252-9240.

1. Mark the important dates

Write these dates on the family calendar:

• September: Review the plan's Annual Notice of Change when it arrives.

• October 1: New Medicare plan information for the upcoming year generally becomes available.

• October 15–December 7: Medicare Open Enrollment for 2027 coverage.

• January 1, 2027: New coverage generally begins.

Open Enrollment is also called the Annual Election Period. During this window, someone with Medicare may be able to:

• Join, drop, or switch Medicare Advantage plans

• Add or drop prescription drug coverage

• Switch from Original Medicare to Medicare Advantage

• Switch from Medicare Advantage back to Original Medicare

• Join, drop, or change a stand-alone Part D prescription drug plan if they have Original Medicare

The right options depend on your parent's current coverage and individual situation.

2. Find the current plan information

Before comparing alternatives, gather the documents that explain your parent's current plan. Useful items include:

• Medicare card

• Medicare Advantage or Part D plan card

• Current plan premium

• Annual Notice of Change

• Explanation of Benefits statements

• Prescription bottles or a current medication list

• Names and contact information for doctors, specialists, and pharmacies

The Annual Notice of Change is especially important. It explains changes to the plan's costs, benefits, coverage rules, and network for the upcoming year.

Read it together and highlight anything that has changed. Pay close attention to new deductibles, copayments, coinsurance, drug costs, provider changes, and coverage limitations.

3. Make an accurate medication list

Prescription coverage can vary significantly from one plan to another. Create a complete list that includes:

• Medication name

• Dosage

• How often it is taken

• Whether it is generic or brand-name

• Preferred pharmacy

• Approximate quantity and refill schedule

Include prescriptions from every doctor, as well as specialty medications, insulin, inhalers, and drugs taken only occasionally. Do not forget over-the-counter products if a healthcare professional has recommended them.

A caregiver can help organize the list, but a doctor or pharmacist should answer questions about whether a medication is medically appropriate. Do not stop, change, or ration a prescription because of cost without speaking with the prescribing healthcare professional.

4. Check the plan's drug coverage

When comparing Part D or Medicare Advantage plans, confirm that every important medication is covered. Look for more than the drug's name. Check:

• Formulary status

• Drug tier

• Copayment or coinsurance

• Deductible

• Quantity limits

• Prior authorization requirements

• Step therapy rules

• Preferred pharmacies

• Mail-order options

• Estimated yearly prescription cost

A plan with a low monthly premium may not be the least expensive overall if your parent takes several costly medications. Medicare's Plan Compare tool allows you to enter prescriptions and compare estimated costs.

Drug prices and plan details can change, so check the information carefully before enrolling. If a medication is not covered, ask the prescribing office or pharmacist whether there are covered alternatives. Do not switch medications without professional guidance.

5. Confirm doctors and specialists are in network

If your parent has established relationships with a primary care doctor, cardiologist, oncologist, orthopedic specialist, or other healthcare professional, check each provider's participation in the plan.

Use the plan's provider directory, then call the doctor's office directly to verify. Direct confirmation is worthwhile because online directories can sometimes be outdated.

Ask:

• Is the doctor accepting this plan for 2027?

• Is the provider in-network or out-of-network?

• Will referrals be required?

• Are there restrictions for specialists?

• Which hospitals and outpatient facilities are included?

• Does the plan cover care when traveling or spending part of the year elsewhere?

A plan may look attractive on paper but create frustration if it disrupts important healthcare relationships.

6. Compare total costs, not just the premium

The monthly premium is only one part of the cost. Review the plan's:

• Annual deductible

• Primary care copay

• Specialist copay

• Hospital costs

• Out-of-pocket maximum

• Prescription deductible

• Drug copayments or coinsurance

• Costs for out-of-network care

• Extra premiums for supplemental benefits

Consider your parent's typical year, not only the current month. Someone who rarely sees a doctor may prioritize a different cost structure than someone managing multiple chronic conditions or frequent specialist visits.

Medicare Advantage plans may offer additional benefits, but these benefits vary by plan and location. Review the exact terms rather than assuming a benefit is unlimited or automatically included.

7. Check pharmacies and everyday access

A pharmacy's location and network status can affect both convenience and cost. Confirm whether your parent's preferred pharmacy is:

• In-network

• A preferred pharmacy

• Available for 90-day refills

• Included in the plan's mail-order program

If your parent has mobility challenges, ask whether mail-order delivery is reliable and whether the medication requires special handling. A nearby pharmacy may also be important for urgent prescriptions.

Families in Houston, Austin, San Antonio, Dallas, and other Texas communities should check the plan's service area using the parent's actual home address. Medicare Advantage plans are often location-specific.

8. Think about care needs beyond insurance

Medicare plan selection is only one part of an aging-at-home plan. Consider what support your parent needs on a typical day:

• Bathing or showering

• Dressing and grooming

• Walking or transferring

• Meal preparation

• Medication reminders

• Grocery planning

• Light housekeeping

• Transportation or errands

• Social engagement and companionship

• Communication with the larger healthcare team

Medicare coverage and private home care services are not the same thing. Medicare may cover certain skilled home health services under specific conditions, but it generally does not pay for ongoing custodial or personal care when that is the only care needed.

If your family is planning daily support at home, explore services separately and ask clear questions about pricing, scheduling, and the type of help provided. Companion Care Home Healthcare provides personal and supportive care in the Houston, Austin, San Antonio, and Dallas areas, including personal care and supportive care services.

9. Get unbiased help before enrolling

Medicare plan information can be difficult to compare, particularly when a parent has several medications or multiple specialists. Free counseling is available through the State Health Insurance Assistance Program, commonly called SHIP.

Texas SHIP counselors can help families understand plan choices without representing a particular insurance company. They may help you:

• Compare Medicare Advantage and Part D plans

• Review prescription coverage

• Understand enrollment periods

• Check whether providers and pharmacies participate

• Identify questions to ask a plan

• Learn about programs that may help with costs

Start with Medicare's contact and local assistance page. You can also call Texas HICAP at 1-800-252-9240.

Be cautious about unsolicited calls, texts, emails, or visitors asking for a Medicare number or financial information. Do not feel pressured to enroll immediately. A legitimate counselor or plan representative should give you time to review the information.

10. Keep a record of the final decision

After choosing a plan, save:

• Plan name and identification number

• Enrollment confirmation

• Effective date

• Customer service number

• Pharmacy and provider information

• Medication coverage details

• Notes from conversations with counselors or plan representatives

Share the relevant information with your parent, trusted family members, doctors, and caregivers. A simple folder, paper or digital, can make future appointments, prescription refills, and coverage questions easier.

If your parent needs help keeping track of appointments, medications, daily routines, or communication with the healthcare team, a dependable in-home caregiver can provide practical support while the family manages the larger care plan. You can contact Companion Care Home Healthcare to discuss available services.

A calmer way to approach Medicare Open Enrollment

You do not have to compare every plan in one sitting. Set aside an hour to gather documents, another to review medications and providers, and additional time to compare costs. When questions arise, use Medicare.gov or a Texas SHIP counselor rather than relying on advertisements or assumptions.

The goal is not simply to choose the plan with the lowest premium. It is to find coverage that fits your parent's doctors, prescriptions, budget, location, and expected healthcare needs for 2027.

Start early, ask questions, and give your family enough time to make a thoughtful decision before December 7, 2026.