How to Review Your Medicare Plan Each Year During the Annual Enrollment Period
Medicare isn’t “set it and forget it.” Plans, drug costs, and your health needs can all change from year to year. A focused review during the Annual Enrollment Period (AEP) (October 15–December 7) can help you avoid surprise bills and make sure your coverage still fits your life.
Start With How You Actually Used Care This Year
Before comparing plans, get clear on your real needs:
- List your doctors and specialists. Note who you see regularly and any providers you must keep.
- Gather your medications. Write down drug names, dosages, and how often you take them.
- Look at this year’s costs. Review statements for premiums, copays, coinsurance, and any big out-of-pocket expenses.
You’re looking for patterns: more doctor visits, new chronic conditions, or medications that are getting expensive.
Check for Plan Changes You Might Have Missed
Plans send an Annual Notice of Change (ANOC) each fall. Don’t ignore it. Focus on:
- Premium increases and changes to deductibles
- New copays or coinsurance for office visits, hospital stays, and tests
- Changes to drug formularies, tiers, or prior authorization rules
- Updates to provider networks and pharmacy networks
If your doctors are leaving the network or your key medications are moving to higher tiers, that’s a strong reason to consider switching.
Compare Your Options by the Numbers
During AEP, review:
- Original Medicare + Medigap + Part D vs. Medicare Advantage (Part C)
- Different Medicare Advantage and Part D plans available in your area
Key factors to compare:
- Total annual cost, not just premiums (include deductibles, copays, and drug costs)
- Maximum out-of-pocket limit (for Medicare Advantage)
- Drug coverage details: formulary, tier placement, preferred pharmacies, mail-order options
- Extra benefits you’ll actually use, such as dental, vision, or hearing
A plan with a slightly higher premium can still save you money overall if it lowers your out-of-pocket spending.
Make Sure Access to Care Stays Easy
Cost isn’t the only piece. Confirm:
- Your primary care doctor and specialists are in-network for any Medicare Advantage plan you consider
- Your preferred hospitals participate in the plan
- You’re comfortable with the plan’s referral rules and prior authorization requirements
- For Part D and Medicare Advantage, your regular pharmacy is in-network and possibly “preferred”
If you travel frequently or live in more than one state, pay special attention to out-of-area coverage and emergency care rules.
Put Your Decision on a Simple Annual Checklist
Each AEP, follow this quick rhythm:
- Review this year’s health changes and costs
- Read your plan’s Annual Notice of Change
- Verify doctors, hospitals, and drugs for next year
- Compare total costs and protections across available plans
- Enroll in your chosen plan before December 7
A short, focused review once a year can prevent unwelcome surprises, keep your doctors and medications covered, and help you stay in control of your Medicare coverage as your life and health needs evolve.