Medicare Annual Enrollment: What to Review Before You Stay Put
If you're already enrolled in Medicare, the Annual Enrollment Period (AEP) isn't about starting over. It's about making sure your current coverage still meets your needs.
From October 15 through December 7, Medicare beneficiaries have the opportunity to review their existing coverage and make changes for the upcoming year if needed. Even if you've been happy with your plan, it's important to remember that Medicare plans can change annually. A few minutes spent reviewing your options now can help you avoid unexpected costs, coverage gaps, or disruptions to your healthcare in the year ahead.
What Can Change Each Year?
Even if your plan keeps the same name, the details behind it may be different next year. During Annual Enrollment, take time to review the following:
Monthly Premiums and Out-of-Pocket Costs
Your monthly premium, deductible, copayments, or maximum out-of-pocket costs may increase or decrease. Looking beyond the monthly premium gives you a more complete picture of what you'll actually spend on healthcare.
Prescription Drug Coverage
Part D prescription drug plans update their formularies each year. Medications may move to different pricing tiers, require prior authorization, or even be removed from the formulary altogether. Reviewing your prescriptions now can help prevent surprises at the pharmacy.
Provider Networks
Doctors, specialists, hospitals, and healthcare systems may join or leave a plan's network. If you have providers you trust, confirm they're still covered before the new plan year begins.
For Maryland residents, this is especially important if your Medicare Advantage plan includes regional health systems such as Johns Hopkins or MedStar, as provider networks and service areas can change from year to year.
Pharmacy Networks
Preferred pharmacy networks can also change. If your regular pharmacy is no longer considered preferred, your prescription costs may increase.
Supplemental Benefits
Many Medicare Advantage plans include additional benefits like dental, vision, hearing, fitness programs, or over-the-counter allowances. These benefits can be added, reduced, or removed each year, making them worth another look.
Your Annual Medicare Review Checklist
Annual Enrollment doesn't have to feel overwhelming. A simple checklist can help you stay organized and make confident decisions:
- Review your medications. Make sure every prescription you take is still covered and check whether any medications have moved to a different pricing tier or require new approvals.
- Verify your preferred pharmacy. Confirm your pharmacy remains in-network and continues to offer the most cost-effective pricing under your plan.
- Check your doctors and specialists. Ensure your primary care physician, specialists, and preferred hospitals are still participating in your plan's network.
- Compare your total healthcare costs. Don't focus solely on the monthly premium. Consider deductibles, copays, coinsurance, and prescription drug expenses to understand the full financial picture.
- Read your plan notices carefully. Insurance carriers send information about upcoming changes before the new plan year begins. These notices often contain important details that are easy to overlook.
- Consider your current health needs. If you've received a new diagnosis, started new medications, or anticipate procedures in the coming year, your current plan may no longer be your best fit.
Why the Annual Notice of Change (ANOC) Matters
Each September, Medicare Advantage and Part D plans send members an Annual Notice of Change (ANOC). While it may look like just another piece of mail, it's one of the most important documents you'll receive during enrollment season.
Your ANOC outlines changes that will take effect on January 1, including:
- Monthly premiums, deductibles, and copays
- Prescription drug coverage and formularies
- Provider and pharmacy network updates
- Changes to supplemental benefits and services
Ignoring this document could mean staying enrolled in a plan that no longer fits your healthcare needs or your budget. Reviewing your ANOC alongside your current medications, providers, and expected healthcare needs makes it much easier to determine whether your existing coverage is still the right choice.
Helping a Parent Through Medicare Enrollment
For many families, adult children and caregivers play an important role during Medicare Annual Enrollment. A little organization can make the process much less stressful.
Start reviewing plan information early so there's plenty of time before the December 7 deadline. Keep medication lists, provider information, insurance cards, and plan documents together in one place to simplify comparisons.
If possible, attend enrollment appointments or phone calls with your loved one. Having another set of ears can help ensure important details aren't missed and questions are answered clearly.
It's also important to watch for warning signs, such as confusion about coverage, rising prescription costs, or skipped medications because they're becoming too expensive. These may indicate it's time to explore other plan options.
For Maryland residents, free counseling is also available through the Maryland State Health Insurance Assistance Program (SHIP), which offers unbiased guidance to help beneficiaries better understand their Medicare choices.
A Trusted Guide During Annual Enrollment
At True North Associates, we believe insurance decisions should always be guided by education, transparency, and your best interests, not by pressure or one-size-fits-all recommendations. Our team helps Medicare beneficiaries throughout Maryland understand plan changes, interpret Annual Notice of Change documents, compare available options, and make informed decisions with confidence.
Whether your current plan is still the right fit or it's time to explore something new, you don't have to navigate Annual Enrollment alone. Having a trusted guide by your side can make Medicare decisions simpler, clearer, and more personalized, both during enrollment season and throughout the year.
