DELAWARE -Medicare open enrollment is underway, and the Delaware Department of Insurance is encouraging beneficiaries to review their health care and prescription drug coverage before the Dec. 7 deadline.
The annual enrollment period runs through Dec. 7, allowing people with Medicare to join, switch or drop a Medicare Advantage plan or Medicare Part D prescription drug plan for 2027.
The Delaware Medicare Assistance Bureau is offering free, confidential, one-on-one counseling to help people compare plans, understand coverage changes and determine whether switching plans could save them money.
“For the third consecutive year, the Medicare Assistance Bureau’s impressive results, saving Delawareans nearly $3.2 million in 2025, highlights the obvious and continuous need for unbiased, expert guidance during Open Enrollment. With a variety of options, annual plan changes, and federal cuts, it remains essential for beneficiaries to take advantage of free services like one-on-one counseling to ensure their coverage meets their health and financial needs” said Insurance Commissioner Trinidad Navarro.
Free Medicare counseling in Georgetown
The Medicare Assistance Bureau is offering in-person appointments at Department of Insurance offices across Delaware from Oct. 20 through Nov. 20.
In Sussex County, appointments are available at:
Delaware Department of Insurance 28 The Circle, Suite 1 Georgetown, DE 19947
Appointments are scheduled for Oct. 22 and 29 and Nov. 2, 12 and 19.
Appointments are required, and walk-ins will not be accepted.
To schedule a free counseling session, call 1-800-336-9500 or 302-674-7364. Phone and virtual appointments are also available.
What Medicare beneficiaries should review before switching plans
The Delaware Department of Insurance is reminding consumers that Medicare Advantage plans can differ significantly from Original Medicare, particularly when it comes to provider networks, prescription drug coverage and out-of-pocket expenses.
Before selecting a plan, beneficiaries should consider several factors:
Doctor and hospital networks: Confirm that preferred doctors, specialists and hospitals accept the plan. Out-of-network care could result in additional expenses or denied services.
Monthly premiums: Medicare Advantage beneficiaries generally must continue paying their Medicare Part B premium and may also owe a separate Medicare Advantage premium.
Additional benefits: Dental, vision, hearing and fitness benefits may be included, but participating providers could be located farther away, including in neighboring states.
Prescription coverage: Check whether current medications are covered and compare potential out-of-pocket expenses.
Plan restrictions: Health Maintenance Organization plans typically have more restrictive provider networks, while Preferred Provider Organization plans generally allow out-of-network care at a higher cost.
Marketing claims: Be cautious of advertisements suggesting Medicare Advantage enrollment automatically increases monthly Social Security payments. Such benefits are not guaranteed and depend on eligibility and plan terms.
The department also warns that most Medicare plan selections remain in effect throughout the following calendar year, although certain enrollment periods and qualifying circumstances may allow changes.
Prescription drug costs capped at $2,400 in 2027
One of the bigger federal changes affecting Medicare beneficiaries in 2027 is a $2,400 annual out-of-pocket cap on covered Medicare Part D prescription drugs.
The cap applies to eligible prescription drug expenses under Medicare Part D, including drug coverage offered through qualifying Medicare Advantage plans.
Beneficiaries can also take advantage of the Medicare Prescription Payment Plan, which allows them to spread out-of-pocket prescription drug expenses across the calendar year rather than paying the full amount at the pharmacy.
Participation is voluntary and free. People who enroll continue paying their regular plan premiums, if applicable, and receive monthly bills from their Medicare drug or health plan for covered prescription costs.
The payment option does not reduce the total amount owed but can make expenses easier to manage throughout the year.
Medicare card replacement raises fraud concerns
The Department of Insurance is also warning Medicare beneficiaries to be alert for scams involving replacement Medicare cards.
Approximately 1.3 million Medicare beneficiaries nationwide began receiving new cards in March 2026 after personal information was potentially compromised in a data breach connected to fraudulent activity.
The replacement cards contain updated Medicare Beneficiary Identifiers and are mailed directly to affected individuals.
Medicare beneficiaries should remember that replacement cards are free, made of paper and do not require activation. Medicare will not call beneficiaries to issue a replacement card.
Anyone unsure whether a replacement card has been issued can call 1-800-MEDICARE or sign in to their account at Medicare.gov.
Common Medicare scams include fraudulent billing for medical services never provided, duplicate charges, unauthorized use of Medicare numbers and offers to enroll beneficiaries in unapproved insurance plans.
People who believe they have encountered Medicare fraud can contact Delaware's Senior Medicare Patrol at 800-223-9074, ext. 2.
Delaware's new Medicare birthday rule provides additional options
Another important change for Delaware Medicare beneficiaries took effect Jan. 1, 2026.
Under Delaware's new Medicare Supplement birthday rule, people who already have Medigap coverage receive an annual special enrollment period allowing them to switch to another Medicare Supplement plan offering equal or lesser benefits without medical underwriting.
The enrollment window begins 30 days before the policyholder's birthday and continues for 30 days afterward.
Insurance companies must notify eligible policyholders about this opportunity.
The law also provides additional protections for Medicare Advantage beneficiaries seeking to return to Original Medicare and obtain Medigap coverage during designated federal enrollment periods.
Those windows include Oct. 15 through Dec. 7 and Jan. 1 through March 31.
However, people switching from Medicare Advantage to Medigap may still face medical underwriting or waiting periods for pre-existing conditions.
Where to get help with Medicare enrollment
The Delaware Medicare Assistance Bureau provides free counseling on Medicare Advantage, Original Medicare, Medicare Supplement insurance, prescription drug savings, long-term care insurance and billing questions.
Counselors can help beneficiaries compare coverage and understand the potential financial consequences of switching plans.
For assistance, call 1-800-336-9500 or 302-674-7364, or visit the Delaware Medicare Assistance Bureau website.
The deadline to make Medicare Advantage and Part D changes for coverage beginning Jan. 1, 2027, is Dec. 7, 2026.
