Navigating Medicare Open Enrollment: Free Help is Available Through PA MEDI
| Living as an Older Adult in PA
From October 15 through December 7, Pennsylvania Medicare beneficiaries have an important opportunity to review their coverage and make changes that could save money, improve access to care, and better meet their health needs for 2026. During open enrollment, new Medicare beneficiaries can sign up for Medicare prescription drug coverage and health plans to complement Medicare, and current Medicare beneficiaries can review, join, switch, or drop Medicare Advantage or prescription drug coverage so it better meets their needs for 2026.
While this annual window is essential, it can feel overwhelming to caregivers and older adults. Medicare plans change every year. Premiums shift, drug formularies are updated, and provider networks adjust.
What's New for 2026
This year brings significant improvements to Medicare coverage. There is now a $2,100 out-of-pocket cap for prescription drugs, an optional prescription payment plan to spread out drug costs throughout the year, and price reductions for 10 medications based on negotiations between the Centers for Medicare & Medicaid Services and participating drug companies.
These changes mean it's especially important to review your options this year as you might find better coverage at a lower cost.
The good news? You don't have to figure it out alone. Your local Area Agency on Aging (AAA) is here to help.
Free, Unbiased Help Through PA MEDI
Pennsylvania Medicare Education and Decision Insight (PA MEDI) provides free, objective health benefits counseling through Pennsylvania's 52 AAAs.
What sets PA MEDI apart from insurance brokers advertising on television? PA MEDI counselors don't sell insurance products. They're trained volunteers and staff who provide unbiased guidance based solely on what's best for your individual situation.
PA MEDI counselors can help you compare all aspects of Medicare Advantage and prescription drug plans, including overall costs, provider networks, and supplemental benefits. They can explain prior authorization requirements and drug formularies, assist with enrolling in a new plan, and determine eligibility for Pennsylvania's Medicare cost-savings programs like PACE/PACENET, Extra Help, and the Medicare Savings Programs.
A Volunteer's Story: Why This Work Matters
For John T. and his wife, both PA MEDI volunteers in Lehigh County, helping others navigate Medicare enrollment is deeply personal. When they went through the Medicare experience themselves, they found it overwhelming. The sales pitches on television were misleading and didn't share the complete picture.
"We wanted to help others make good decisions and be on top of the changes every year as your medications change," John explains. "The advantage plans change every year. It is easy to be confused."
Most volunteers are Medicare-age themselves, bringing personal understanding to their counseling. The individuals attend monthly training to stay current on program changes, so you can trust you're getting the most up-to-date information.
Take the Next Step
Whether you're new to Medicare or a long-time beneficiary, open enrollment is your opportunity to ensure your coverage works for you. Don't navigate this important decision alone.
Reach out to your local AAA for help connecting with PA MEDI services. You can also call the PA MEDI Helpline at 1-800-783-7067 (Monday through Friday, 8:00 AM to 5:00 PM).
Pennsylvania's free Medicare counseling can help you understand the complete picture and find coverage that truly fits your needs. They are here to help you make the best decision for your health and your budget.