Medicare Open Enrollment Charleston 2026

Choosing the Right Medicare Plan for 2026

Fall is a time for old classics and special traditions like cheering for your team during the World Series and sitting down to dinner with friends and family at Thanksgiving. As the temperatures begin to fall and the leaves begin to turn, you also might want to seriously think about your health insurance for the coming year.

If you are a Medicare recipient – because you’ve reached the age of 65 or are disabled – you get to choose your health care options during the open enrollment period, which runs from Oct. 15 through Dec. 7.

Reviewing Your Options During Open Enrollment

What are the best and most affordable Medicare options in the Charleston area in 2026? Choose wisely, because you’ll be locked into the choices you make for the next year. Except under certain exceptions, this is the only time you’ll be able to make changes.

Angela Edwards, state health insurance assistance program coordinator for the Trident Area Agency on Aging, helps recipients navigate through their Medicare and Medicaid options. Even if you’re already enrolled in a government-sponsored plan, she recommended taking a close look at your selections because things can change, and changes can cost you money or disrupt your eligibility.

It’s normal to lose a few plans each year, but, in 2025, seven plans were eliminated, she said, which ended up costing some people higher deductibles or brought changes to drug coverage. Plans with varying levels of coverage are available. When making your selection, she recommended comparing the plans and asking yourself, “What is it that you want the plan to do for you?” As an example, she pointed out that some people prefer stand-alone drug plans.

Like other health care plans, it takes special circumstances to qualify to make changes after the Dec. 7 deadline and before open enrollment begins again in October. For example, you might move to an area where your current plan is not available.

Understanding Medicare Advantage Plans

Many Medicare recipients have signed up for Medicare Advantage plans to take advantage of lower office visit copays. Medicare Advantage Plans bundle hospital services and doctor care, as well as prescription drug coverage, which you must purchase separately if you are using traditional Medicare.

The downside to Medicare Advantage Plans is that they offer a smaller list of in-network doctors, and you might need pre-authorization from your doctor to see some specialists, which traditional Medicare doesn’t require, Consumer Reports warned in a 2022 article. The bottom line is that you might end up paying more for your health care, and, in addition, having fewer choices might be especially problematic for those who live in rural areas, the publication noted.

Medicare Advantage Plans offer dental and vision options. Traditional Medicare doesn’t, but stand-alone plans are available in the open market.

How to Decide Between Advantage and Traditional Medicare

There’s no “right plan” that’s perfect for everyone, according to both James Brown and Dayle Guidera, local independent insurance agents who work with the Gilston Insurance Agency in Charleston. Because of the lower premiums, Medicare Advantage makes the most sense for seniors who are healthy, said Brown, adding that there are variables to consider since Advantage plans are fully privatized.

Guidera pointed out that if you have to switch doctors, Medicare Advantage doesn’t make sense. She said premiums are less than with traditional Medicare, but costs can vary depending on which plan you choose and what part of the country you call home.

In terms of insurance companies, Guidera works primarily with local juggernaut Blue Cross Blue Shield. While there’s much competition in the health insurance industry, some companies come and go, but Blue Cross is solid and offers discounts if multiple household members are enrolled, she said.

Supplemental Coverage and Expert Guidance

Medicare recipients also can purchase Medigap coverage – supplemental insurance sold by private companies that pays for items not covered by traditional Medicare, such as deductibles and co-payments.

Brown and Guidera both pointed out that their job is to help people find the right fit for their needs. “If people come to me, I can help them with different plans,” Guidera said, while Brown added that “The majority of what I do is answer questions and give advice.”

Resources for Medicare Recipients

Angela Edwards of the Trident Area Agency on Aging suggested the following resources for Medicare recipients looking for help in selecting the health insurance plan that is right for them: