You’re happy with your doctors. Your prescriptions haven’t changed. Your Medicare coverage worked well this year. So, is reviewing your plan really necessary?
It’s a worthwhile step. Your healthcare needs may stay the same while your plan’s costs and coverage change. Taking time to review the details this fall can help you make a more informed decision about the year ahead.
Medicare Open Enrollment runs October 15 through December 7 each year. Changes made during this period take effect January 1, as long as the plan receives your enrollment request by December 7. That means this fall’s enrollment decisions affect your coverage for 2027.
Start With the Notice You Might Be Tempted to Skip
If you have a Medicare Advantage or prescription drug plan, your plan sends an Annual Notice of Change, often called an ANOC, each fall. It explains changes to costs, coverage, and other plan details that begin in January.
Before filing it away, look for anything that could affect the care you use or what you pay. Even if you recognize the plan’s name, don’t assume next year’s coverage will be identical to this year’s.
Put Your Prescriptions Near the Top of Your List
When comparing coverage, start with the medications you actually take. Medicare drug plans can differ in both the prescriptions they cover and their costs.
Prepare a current list that includes each medication’s name, dosage, and how often you fill it. Include your preferred pharmacy, too.
During your review, ask:
- Will each of my prescriptions be covered next year?
- What is the estimated annual cost for my medications?
- Are there coverage requirements I should understand?
- How do costs compare at the pharmacies I’m willing to use?
Bring the actual list to your appointment instead of relying on memory. That gives your advisor a more useful starting point for comparing options.
Make Your Doctors Part of the Conversation
If keeping your current doctors is a priority, say so at the beginning of your review.
Ask your advisor to help verify your primary care doctor, specialists, and preferred hospital under the specific plan you’re considering. Confirm participation with the providers’ offices as well.
Be specific: “Do you accept this exact plan?” is a more useful question than simply asking whether an office accepts Medicare.
Also mention any planned procedures, ongoing treatment, or time you expect to spend away from home. These details belong in the discussion before you choose coverage.
Look Beyond the Monthly Premium
A monthly premium is an easy number to compare, but it shouldn’t be your only question.
Ask for a review that considers premiums alongside deductibles, copayments, coinsurance, and the services you expect to use. Discuss what your costs could look like during both a routine year and a year when you need more care.
A helpful question is:
“How would this coverage work for me if I needed more appointments, tests, or treatment than I did this year?”
That moves the conversation toward your needs and budget.
Understand That Medigap Follows Different Rules
Medicare Supplement insurance, also called Medigap, has different enrollment protections.
The fall Medicare Open Enrollment period does not create an automatic annual right to buy or switch Medigap coverage without health-related restrictions. Your federal Medigap Open Enrollment Period generally lasts six months, beginning when you are 65 or older and enrolled in Part B. Other protections may apply depending on your circumstances and state.
If you’re considering leaving Medicare Advantage for Original Medicare and want a Medigap policy, check your eligibility and options before making the change.
A Review Doesn’t Mean You Have to Switch
The purpose of an annual review is to find out whether your coverage still fits.
You may discover that your current plan continues to meet your needs. You may find a reason to consider something different. Either way, the decision should reflect your prescriptions, providers, budget, and preferences.
Get Ready for a More Productive Medicare Review
Before meeting with an advisor, gather:
- Your current plan information and Annual Notice of Change.
- An updated medication list and preferred pharmacies.
- The names of your doctors and specialists.
- Questions about costs or coverage from the past year.
- Any expected changes in your healthcare needs.
Have questions about your Medicare coverage for the coming year? Contact our office to schedule a personalized review. We’ll help you understand your options so you can make an informed decision before December 7.