Medicare Open Enrollment 2026: What Richmond Families Should Check Before December 7
First, take a breath. This stuff is confusing for everybody, and if you're reading this because something feels off with your mom's coverage, you're already doing the right thing.
Here's the honest truth: Most people keep the same Medicare plan year after year and never look at it again. And honestly, that works fine... until a parent's health changes. Then it really doesn't.
That thick envelope from her plan is probably buried on the kitchen counter under a stack of mail. And her phone has been ringing off the hook with people offering a "free plan review." We get it, it's a lot.
But if she had a new diagnosis this year, or a hospital stay, or picked up a new prescription, or spent any time in rehab, please open the envelope. It's worth the hour.
Medicare Open Enrollment runs October 15 through December 7, 2026. Whatever she picks (or doesn't pick) kicks in January 1, 2027. That's your window.
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The Part D drug cap goes up to $2,400, from $2,100. The standard deductible climbs to $700.
Plans themselves shift too. Premiums move, drug lists change, networks shrink, and some plans are cutting benefits or pulling out of certain areas altogether. It's a lot of moving parts!
The 2027 Part B premium hasn't been announced yet. In 2026, it's $202.90 a month.
That envelope I mentioned? It's called the Annual Notice of Change, and it lays out exactly what's different for her plan next year. Start there. Really, that's where to start.
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Doctors. Call every single office and ask if they'll take that specific plan in 2027. Please don't just take a sales rep's word for it — I've seen too many families get burned.
Hospitals. Check VCU Health, Bon Secours (St. Mary's, Memorial Regional, St. Francis), and HCA (Chippenham, Johnston-Willis, Henrico Doctors').
Medications. Every prescription, with the dose, goes into the Plan Finder at Medicare.gov. All of them. Yes, even the ones she only takes sometimes.
Rehab facilities. This one surprises people. A lot of Medicare Advantage plans only cover certain rehabs, and they want approval first. Most families don't find this out until a discharge planner is asking them to pick a place in two days, which is a brutal way to learn it.
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Medicare doesn't pay for assisted living. I know, that's a hard one. Whatever plan she picks this fall won't cover the rent or the day-to-day help in assisted living or memory care.
But the plan still matters a lot if a move is coming. A lot of communities use one pharmacy and have doctors who come on site. If her plan doesn't line up with any of that, guess who's driving her to appointments? You. So it's worth checking now.
One more thing nobody tells you: going back to Original Medicare isn't always simple. Medigap insurers can ask health questions and turn her down. Virginia's birthday rule, nice as it is, doesn't help somebody leaving an Advantage plan. Just something to know going in.
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We wish there was a clean answer here. Advantage usually costs less month to month but comes with networks and prior approvals. Original Medicare plus a supplement costs more but she can see any provider that takes Medicare, which is most of them. It really does come down to how much care she's likely to need next year. The more care she needs, the more Original Medicare tends to look like the better fit, assuming she can still get a supplement.
Free, Unbiased Help: Your SHIP Counselor
Here's the best-kept secret in all of this: Every state has a SHIP (State Health Insurance Assistance Program). It's federally funded, the counseling is completely free, and the counselors don't sell insurance or get commissions. They're on your side. Virginia's version is called VICAP, the Virginia Insurance Counseling and Assistance Program.
A SHIP counselor can:
Compare 2027 plans using her actual doctors, hospitals, and prescriptions.
Check for savings programs like Extra Help with drug costs or a Medicare Savings Program that pays the Part B premium (yes, that's a real thing!).
Help sort out a confusing bill or a denied claim.
How to reach VICAP: Call 1-800-552-3402. In Richmond, counseling runs through The Span Center (formerly Senior Connections). Appointments fill up fast this time of year, so call this week if you can. If you're helping a parent in another state, find their SHIP at ShipHelp.org.
You can also call 1-800-MEDICARE (1-800-633-4227) anytime, day or night.
Look, none of this is simple. It just isn't. But an hour at the kitchen table with your mom in October can save you both a lot of grief in January. You've got this.
ViaVera helps families right here in Richmond, Henrico, and Chesterfield figure out how Medicare, Medicaid, and private pay fit into senior living decisions. Our help is always free to families. If you want to talk through what her coverage will and won't pay for, reach out anytime. We're happy to help.
