By Tucson Senior Advisor Care Team · October 27, 2026
Medicare's annual open enrollment runs October 15 to December 7. Pima Council on Aging's SHIP counselors ((520) 546-2011) compare plans for free. If a parent may need rehab or a nursing home, check networks and prior-authorization rules, not just premiums.
When is Medicare open enrollment?
Medicare's annual open enrollment runs from October 15 through December 7, with changes taking effect January 1. During that window people can switch between Original Medicare and Medicare Advantage, change Advantage plans, and change Part D drug plans.
A separate Medicare Advantage open enrollment period from January 1 through March 31 allows one change for people already in an Advantage plan.
Why does plan choice matter more when care needs are growing?
Medicare Advantage plans use provider networks and often require prior authorization for skilled nursing rehab, home health and some equipment. A parent with frequent hospital visits may care more about which Tucson nursing homes are in network than about a lower premium.
Original Medicare with a supplement has no network for rehab, but it costs more each month. There is no single right answer; there is a right answer for a specific person's doctors, drugs and likely care.
What should you check for a parent in assisted living?
Check that the parent's primary care provider and any visiting physician group are in network, that the pharmacy the facility uses is a preferred pharmacy for the drug plan, and how the plan handles home health visits in an assisted living apartment.
Remember that Medicare does not pay assisted living rent or personal care. Plan changes affect medical costs, not the monthly facility bill.
Where can Pima County families get unbiased help?
Pima Council on Aging is Pima County's State Health Insurance Assistance Program. Its counselors give free one-on-one help at (520) 546-2011 or by email, and they neither sell nor endorse plans. PCOA also offers free Understanding Medicare presentations listed on its calendar.
Counselors can also screen for help paying premiums and drug costs; PCOA lists income limits of $1,581 a month for an individual and $2,134 for a couple for those programs.
How do Medicare and ALTCS work together?
People who qualify for both Medicare and ALTCS are dually eligible. Medicare stays primary for medical care, and ALTCS covers long-term care services. Dually eligible members have special enrollment options and plan types designed for them, which a SHIP counselor can explain.
| Need | Usually paid by |
|---|---|
| Hospital and doctor visits | Medicare (or Advantage plan) |
| Short rehab after a hospital stay | Medicare, limited days |
| Long-term nursing home care | ALTCS for eligible members, otherwise private |
| Assisted living care services | ALTCS for eligible members, otherwise private |
| Assisted living rent | the resident |
What should you bring to a SHIP appointment?
Bring every Medicare card and plan card, a complete list of prescriptions with doses, the names of the doctors and hospitals your parent wants to keep, and any letters from the current plan about changes for next year, often called the annual notice of change.
With that list, a counselor can compare drug costs and networks in one sitting. Without it, the appointment usually ends with homework and a second visit.
What changes most often from one year to the next?
Premiums, drug formularies, pharmacy networks and provider networks are the items that change most often. A plan that worked well this year may drop a pharmacy or move a drug to a more expensive tier next year, which is why reviewing the plan every fall matters even when nothing feels wrong.
Prior authorization rules for rehab and home health can also change, and they matter most for people whose health is fragile. A counselor can show which plans in Pima County require prior authorization for skilled nursing rehab, so a family is not surprised when a hospital discharge is planned.
Medicare: what it pays and does not pay in senior care
| Pays | Does not pay | |
|---|---|---|
| Rehab | limited skilled nursing days after an inpatient stay | long-term nursing home care |
| Home | home health and hospice | hourly custodial care |
| Assisted living | medical care received there | rent or personal care |
Frequently asked questions
Is SHIP counseling really free in Pima County?
Yes. PCOA's SHIP program provides free one-on-one Medicare counseling and does not sell or endorse plans. Call (520) 546-2011 for an appointment.
Can I change plans if my parent moves to a nursing home?
Moving into or out of a nursing home creates special enrollment opportunities outside open enrollment. A SHIP counselor can confirm which apply.
Does Medicare Advantage cover assisted living?
No. Medicare Advantage plans cover medical services like Original Medicare does, and some offer extra benefits, but they do not pay assisted living rent or long-term personal care.
What if my parent has both Medicare and ALTCS?
Medicare remains primary for medical care and ALTCS covers long-term care services. Dually eligible people have specific plan options; ask a SHIP counselor or the ALTCS health plan.
Is Medicare open enrollment the only time to change plans?
No. Moving, entering or leaving a nursing home, qualifying for help with costs, and some other events create special enrollment periods. A SHIP counselor can tell you whether one applies before you wait for the fall.
Can I get Medicare help in Spanish in Pima County?
Ask PCOA when you call; it serves a bilingual county and its programs publish materials in English and Spanish. Medicare also offers interpreter services through 1-800-MEDICARE.
