Medicare's Annual Enrollment runs Oct 15 to Dec 7. Here is how San Diego seniors can review drug and doctor coverage and get free help.
By Marcus Reyes, LSW · October 02, 2026
Every year between October 15 and December 7, people with Medicare can change how they get their coverage. You can switch from Original Medicare to a Medicare Advantage plan, move back, change Advantage plans, or pick a different Part D prescription drug plan. Changes take effect on January 1. If you do nothing, your current plan usually renews, but plans change their premiums, drug lists, copays and provider networks every year.
In San Diego County, that yearly shuffle matters more than many families expect. Medicare Advantage networks here are built around specific medical groups and hospital systems, and a doctor or specialist your parent has seen for ten years may be in or out of network from one January to the next. A plan that worked last year can quietly become a poor fit after a new diagnosis, a move, or a change in medications.
Start with the plan's Annual Notice of Change, which most plans mail by late September. It lists what is changing in premiums, deductibles, drug coverage and networks for the new year. Read it before the enrollment period begins, because it is the plainest summary of what you are about to get.
Then check three things in order. First, confirm every current doctor, specialist and preferred hospital is in the network for 2027, by calling the provider's billing office rather than relying only on the plan's online directory. Second, enter every prescription, with exact dose, into the Medicare Plan Finder at medicare.gov and compare the total estimated yearly cost, not just the monthly premium. Third, look at the out-of-pocket maximum and the costs of the services your parent actually uses, such as specialist visits, skilled nursing stays, home health and ambulance rides.
If your parent lives in or is about to move into assisted living or a skilled nursing facility, ask whether the facility's contracted pharmacy and visiting physicians work with the plan. Some Advantage plans require prior authorization for rehab stays, which can slow a hospital discharge, so it is worth asking how the plan handles it before you need it.
Original Medicare lets you see any provider that accepts Medicare, but it has no out-of-pocket cap unless you add a Medigap supplement. Medigap policies can fill that gap, though in California the rules for switching to one later can be restrictive, and insurers may be able to ask health questions or decline you outside of certain protected windows. That is a serious reason to talk with a counselor before dropping a Medigap policy you already have.
Medicare Advantage plans often carry lower or zero premiums and bundle extras like dental, vision and hearing, but they use networks and prior authorization. Neither choice is right for everyone. The better question is which one fits your parent's health, budget and doctors for the year ahead. Our guide on Medicare Advantage versus Original Medicare walks through that comparison in more detail.
Also keep in mind that people on both Medicare and Medi-Cal, or those who qualify for Extra Help with drug costs, may have special enrollment rights that go beyond the fall window. Ask a counselor to check before assuming you are locked in.
You do not need to rely on a broker or a mailer. California's Health Insurance Counseling and Advocacy Program, known as HICAP, provides free, one-on-one Medicare counseling from trained volunteers and staff who do not sell insurance. You can reach HICAP statewide at 1-800-434-0222, or start with Aging and Independence Services, the San Diego County Area Agency on Aging, at 800-339-4661, which can connect you to local counseling. Appointments fill up quickly in late October and November, so call early.
For general questions, 1-800-MEDICARE (1-800-633-4227) is available around the clock. Bring your Medicare card, a list of medications with doses, the names of your doctors and pharmacies, and your current plan's Annual Notice of Change. If a family member is helping, ask your parent to give written permission so the counselor can speak with you.
If you receive a call or text pressuring you to switch plans immediately, treat it as a red flag. Legitimate plans and agents are limited in how they can contact you, and no one from Medicare will call uninvited to ask for your Social Security or bank information.
Free, no-pressure call. We work for families, not facilities.