Medicare 2026

Have Medicare in San Leandro? Your AEP Checklist

SAN LEANDRO, Calif. — The fall window to review Medicare coverage is open. From October 15 through December 7, people with Medicare across Alameda County can compare plans, switch, or make changes that take effect January 1, 2027. Missing that date usually means waiting another year.

This is also the season when the 2027 program numbers come into focus, including the annual cap on what you pay out of pocket for Part D prescription drugs, which rises to $2,400. Here is a plain-English guide to what you can actually do during the Annual Enrollment Period (AEP), and how to decide.

What the Annual Enrollment Period actually lets you do

AEP is the once-a-year window when almost anyone with Medicare can make coverage changes without needing a special reason. During October 15 – December 7, you can:

• Switch from Original Medicare (Parts A and B) to a Medicare Advantage plan, or the other way around.
• Change from one Medicare Advantage plan to a different Medicare Advantage plan.
• Join a stand-alone Part D prescription drug plan, switch to a different one, or drop your drug coverage.

Whatever you choose takes effect on January 1, 2027. If you do nothing, your current coverage generally rolls over into next year — but the plan itself may have changed, which is why a yearly review matters.

Read your Annual Notice of Change

By late September, your current Medicare Advantage or Part D plan should have sent an Annual Notice of Change (ANOC). It spells out what is different for 2027 — premium, deductible, drug list (formulary), pharmacy network, and provider network.

Two questions to ask as you read it:

1. Are the doctors, hospitals, and pharmacies I use still in-network next year? 2. Are the specific medications I take still covered, and at what tier?

If the answer to either question is no, that's a strong signal to compare other options before December 7.

The 2027 numbers to keep in mind

A few program-level facts apply no matter which plan you pick:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once your covered drug spending hits that ceiling, you pay nothing for covered drugs the rest of the year.
• Part D deductible: no plan can charge more than $615 in 2026, rising to $700 in 2027.
• The "donut hole" is gone. As of 2025, Part D has just three phases (deductible, initial coverage, catastrophic), and that continues in 2027.
• Medicare Prescription Payment Plan: an optional program that lets you spread your drug costs across monthly payments instead of paying big amounts at the pharmacy counter. You can opt in through your drug plan.
• IRMAA: higher-income beneficiaries pay surcharges on Part B and Part D. For 2026, these begin above $109,000 in income for a single filer.

How to compare plans without getting overwhelmed

San Leandro is in Alameda County, where Medicare beneficiaries typically have a wide range of Medicare Advantage and stand-alone Part D plans to choose from. That's good news, but it can be a lot to sort through. A simple approach:

1. List your must-haves. Your doctors, your preferred hospital (many locals use facilities in San Leandro, Oakland, or Hayward), your regular pharmacy, and every prescription you take with dose and frequency. 2. Use the Plan Finder at medicare.gov. Enter your ZIP code and your drug list. The tool will estimate your yearly costs under each plan, including premiums and drug costs. 3. Check the networks yourself. Call the plan or check its online directory to confirm your providers are in-network for 2027. 4. Look at Star Ratings as one data point. CMS rates plans on quality and service from 1 to 5 stars. It's useful context, not the whole story.

If December 7 passes

If you miss AEP, you still have some options. From January 1 – March 31, the Medicare Advantage Open Enrollment Period lets people already in a Medicare Advantage plan switch to a different Advantage plan or drop back to Original Medicare (with a Part D plan). Certain life events — moving, losing other coverage, qualifying for Extra Help — can also trigger a Special Enrollment Period.

Watch out for pressure and scams

AEP is peak season for aggressive sales calls, door knocks, and misleading TV ads. Medicare will not call you out of the blue to "verify" your number or sign you up. If someone pressures you to decide on the spot, that's a red flag. Hang up and call 1-800-MEDICARE or your local SHIP counselor.

Where San Leandro readers can get free help

• Medicare: 1-800-MEDICARE (1-800-633-4227), 24/7, or medicare.gov.
• California SHIP (HICAP): free, unbiased Medicare counseling. Alameda County residents, including in San Leandro, can reach HICAP through the state SHIP line at 1-800-434-0222.
• Social Security: ssa.gov or 1-800-772-1213 for enrollment and IRMAA questions.