Medicare education · Clinton, NC
Medicare Annual Enrollment Period in Clinton, NC: 2026 review guide
A practical guide to reviewing Medicare plan changes, provider participation, drug coverage, and costs during the Annual Enrollment Period.
The bottom line
- The Annual Enrollment Period runs October 15 through December 7; eligible changes generally take effect January 1.
- CMS finalized the standard Part D deductible and out-of-pocket threshold for 2027 at $700 and $2,400, respectively.
- Provider participation, formularies, premiums, and benefits vary by plan and coverage year. Verify details before enrolling.
- Price Services Group can help review plans it represents in your area; it does not offer every plan available.
The Medicare Annual Enrollment Period (AEP) runs October 15 through December 7 each year. It gives eligible people an opportunity to make certain Medicare Advantage and Part D changes. The choices available depend on current coverage and individual circumstances; check the applicable enrollment rules before acting.
What can I change during AEP?
During AEP, eligible people may make certain changes involving Medicare Advantage and Part D coverage. Plan changes generally take effect January 1. AEP does not make every type of change available to every beneficiary, and it does not create a new Medigap enrollment right.
| Coverage year | Standard Part D deductible | Part D out-of-pocket threshold |
|---|---|---|
| 2026 | $615 | $2,100 |
| 2027 | $700 | $2,400 |
Sources: CMS 2026 Part D instructions and CMS 2027 Rate Announcement.
These are standard-benefit amounts, not an estimate of an individual's total prescription costs. The Part D out-of-pocket threshold excludes premiums and costs for drugs not covered by a plan. Actual premiums, formularies, cost sharing, and coverage rules vary. See Medicare.gov's Part D cost guidance.
How should I review my Annual Notice of Change?
Read the notice for the plan year you are considering and compare it with your needs. Pay particular attention to:
- Premiums, deductibles, copayments, and applicable out-of-pocket limits.
- Your prescriptions, formulary tiers, prior authorization rules, and preferred pharmacies.
- Provider-directory changes and whether your doctors or facilities participate in the specific plan.
- Changes to extra benefits and the plan's eligibility or service-area rules.
How do I check whether my doctors participate?
Provider networks differ by plan and can change between coverage years. Check the plan's current provider directory, then confirm directly with both the plan and the doctor or facility that the provider participates in that specific plan and network. A directory entry is a starting point, not a guarantee of participation or coverage for a particular service.
Where can I compare plans for 2027?
Use Medicare.gov Plan Compare with your ZIP code and coverage needs. Review the plan's 2027 Evidence of Coverage, provider directory, and formulary. Compare premiums and cost sharing alongside drug and provider details; a county listing alone does not establish that a plan covers your prescriptions or includes your providers.
Does AEP change my Medigap rights?
No. AEP is not a Medigap enrollment period. The one-time federal Medigap Open Enrollment Period lasts six months and begins when a person is 65 or older and enrolled in Part B. Federal guaranteed-issue rights and state protections may also apply in some circumstances. Outside applicable protections, an insurer may use medical underwriting. Review Medicare.gov's Medigap guidance and contact the North Carolina Department of Insurance about state rules.
Want help reviewing your options?
Bring your current plan information, prescriptions, and providers. We can help review plans Price Services Group represents in your area.
Start a plan review →This article is educational and is not an eligibility, coverage, or enrollment decision. Plan availability and terms vary by ZIP code, plan, and coverage year. Confirm current information with Medicare.gov, the plan, and a licensed agent. Price Services Group is an independent licensed agency and does not offer every plan available in your area.
Frequently asked questions
When is the Medicare Annual Enrollment Period in 2026?
The Annual Enrollment Period (AEP) runs October 15 through December 7 each year. Changes made during AEP generally take effect January 1. Which changes you can make depends on your current coverage and circumstances.
Can I switch from Medicare Advantage to Original Medicare during AEP?
AEP allows eligible people to make certain Medicare Advantage and Part D changes, including returning to Original Medicare. If you want Medigap, check your federal guaranteed-issue rights and North Carolina protections before disenrolling. Outside your one-time six-month Medigap Open Enrollment Period, an insurer may use medical underwriting unless a guaranteed-issue right or state protection applies. See <a href="https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/when">Medicare.gov's Medigap timing guidance</a>.
Where can I compare Medicare plans for Clinton, NC?
Plan options and costs depend on ZIP code and coverage year. Use <a href="https://www.medicare.gov/plan-compare">Medicare.gov Plan Compare</a> for current options, then review the plan's Evidence of Coverage, formulary, pharmacy rules, and provider directory. Price Services Group can help review plans it represents in your area.
What is the 2026 Part D out-of-pocket threshold?
The 2026 standard Part D out-of-pocket threshold is $2,100. CMS finalized a $2,400 threshold and $700 standard deductible for 2027. The threshold excludes premiums and costs for drugs not covered by the plan. See <a href="https://www.medicare.gov/health-drug-plans/part-d/basics/costs">Medicare.gov's Part D cost guidance</a> and the <a href="https://www.cms.gov/files/document/2027-announcement.pdf">CMS 2027 Rate Announcement</a>.
What should I look for in my Annual Notice of Change?
Review changes to premiums, deductibles, copayments, drug tiers, pharmacy rules, provider participation, and extra benefits. Compare the documents for the coverage year you are considering and confirm details with the plan and providers.
Does Medicare AEP apply to Medigap plans?
No. AEP is for Medicare Advantage and Part D changes, not Medigap. The one-time federal Medigap Open Enrollment Period lasts six months and starts when you are 65 or older and enrolled in Part B. Guaranteed-issue rights or state protections may also apply in some situations. See <a href="https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/when">Medicare.gov's Medigap guidance</a> and the North Carolina Department of Insurance.