Medicare Open Enrollment 2027 in Ocean County, NJ: What to Check Before December 7

If you live in Toms River, Brick, Manahawkin, Lakewood, Barnegat or anywhere else in Ocean County, you have probably noticed the Medicare mail and TV ads piling up. That is because Medicare Open Enrollment is here. It runs from October 15 through December 7, 2026, and any change you make takes effect on January 1, 2027.

The good news: you do not have to sort through it all alone. Below is a simple checklist of what to look at before the December 7 deadline, written for real people, not insurance experts.

What You Can Do During Open Enrollment

Between October 15 and December 7, you can:

• Switch from one Medicare Advantage plan to another

• Move from Original Medicare to a Medicare Advantage plan, or from Medicare Advantage back to Original Medicare

• Join, drop or switch your Medicare drug coverage

• Keep the plan you have

If you review your options and you are happy with your current coverage, you do not need to do anything. Your plan continues automatically. But plans can change their costs, benefits and doctor networks every year, so a quick review is always worth it. Just remember that the plan must receive your enrollment request by December 7.

Step 1: Read Your Annual Notice of Change

If you are in a Medicare Advantage or drug plan, your plan sends you an Annual Notice of Change (often called the ANOC) each fall, usually in September. It lists what is changing for January.

When you read it, look for changes to:

• Your monthly premium

• Copays for doctor visits, specialists and hospital stays

• Your deductible and yearly out-of-pocket limit

• Your drug list and which tier each of your medications is on

• Extra benefits like dental, vision or hearing

Did not get one, or tossed it with the junk mail? Call the member services number on the back of your plan card and ask for a copy.

Step 2: Check Your Doctors, Hospitals and Pharmacy

This is the step people skip most, and the one that causes the most headaches in January. Medicare Advantage plans usually use a network, and networks can change from one year to the next.

Before December 7, make a list of:

• Your primary care doctor and every specialist you see

• The hospital you would want to go to

• Your pharmacy, including any mail-order pharmacy

Then confirm each one is in network for 2027. It is smart to ask the doctor's office directly, too. If you split your time between the Jersey Shore and somewhere warmer in winter, also check how the plan covers you out of state.

Step 3: Review Your Drugs and the 2027 Part D Cap

Here is some good news for 2027. Medicare has set the yearly out-of-pocket limit for covered Part D drugs at $2,400 in 2027 (up from $2,100 in 2026). Once your out-of-pocket spending on covered drugs reaches that amount, you pay $0 for covered Part D drugs for the rest of the year. The highest deductible any Medicare drug plan can charge in 2027 is $700, and some plans have no deductible at all.

One important catch: only covered drugs count toward that $2,400 cap. If one of your medications is not on your plan's drug list, what you pay for it does not count. The same is true when you buy a drug with a discount card instead of your Medicare plan. That is why it matters so much to check that every one of your prescriptions is covered by the plan you pick for 2027.

Have your list of medications, with the dose, handy when you compare plans. Our prescription assistance page explains more about lowering drug costs.

Step 4: Medigap or Medicare Advantage? A Quick Refresher

Open Enrollment is also when some people think about switching between Medicare Advantage and Original Medicare. In short:

• Original Medicare with a Medigap (Medicare Supplement) plan lets you see any doctor or hospital in the U.S. that takes Medicare, usually without referrals. You would add a separate drug plan.

• Medicare Advantage plans usually use a network, often include drug coverage and extras like dental or vision, and have a yearly limit on what you pay for covered services. You may need referrals or prior approval for some care.

A word of caution: if you have a Medigap policy now and drop it to join a Medicare Advantage plan, you may not be able to get the same Medigap policy back later. Talk it through before you make that move. Our page on Medicare Advantage vs. Supplements walks through the differences in more detail.

Step 5: See If You Qualify for Help Paying

Many Ocean County seniors pay more than they need to because they never apply for help. Three programs to know:

• Extra Help is a Medicare program for people with limited income and resources. In 2026, the limits are $23,940 in income and $18,090 in resources for an individual, or $32,460 in income and $36,100 in resources for a married couple. In 2027, people with Extra Help pay a $0 plan premium and $0 deductible, and no more than $5.80 for each generic and $14.40 for each brand-name drug at plan pharmacies. You can apply through Social Security.

• PAAD (Pharmaceutical Assistance to the Aged and Disabled) is a New Jersey program. For 2026, your income must be less than $54,943 if single or less than $62,390 if married. Copays are $5 for covered generics and $7 for covered brand-name drugs. There is no limit on resources.

• Senior Gold is another New Jersey program for people with incomes a bit higher than PAAD: for 2026, between $54,943 and $64,943 if single, or between $62,390 and $72,390 if married.

Both PAAD and Senior Gold are for New Jersey residents age 65 or older (or receiving Social Security disability benefits), and you apply for both with the state's NJSave application. Both programs require you to have Medicare Part D coverage. If you are on PAAD, plan choice matters, because PAAD pays the premium only for certain Part D plans. We are happy to check that with you.

Missed Something? The January 1 to March 31 Window

If you are already in a Medicare Advantage plan and realize in January that it is not working for you, there is a second chance. The Medicare Advantage Open Enrollment Period runs from January 1 through March 31. During that time you can switch to another Medicare Advantage plan, or drop your plan and return to Original Medicare (and join a separate drug plan). Still, it is much easier to get it right before December 7.

Local Help From Someone Who Lives Here

Holowchuk Health Advisors is based right here in Manahawkin, and we help people all across Ocean County, including Toms River, Brick, Manahawkin and Stafford, Lakewood and Barnegat.

As an independent broker, we work with 20+ carriers, so we can compare options side by side instead of pushing one company. We have helped 1,155+ clients, and we are proud of our 5.0 rating with 220+ Google reviews. We are available Monday through Saturday, 9am to 8pm.

Not sure if your current plan still fits? Start with a free Medicare plan review. We will check your doctors, your drugs and your costs for 2027, and explain everything in plain English.

Do not wait until the last week. December 7 comes fast. Book your appointment with Tom today and head into 2027 with confidence.