Medicare basics
Medicare Annual Enrollment Period: What to Review Every Fall
6 minute read
Every fall, Medicare gives you a window to review your coverage and make changes for the coming year. Many people keep the same plan without checking it, and then discover in January that a medication moved to a higher tier or a favorite doctor left the network. A short review each fall can prevent both surprises.
When the Annual Enrollment Period happens
The Medicare Annual Enrollment Period runs from October 15 through December 7 each year. Changes you make during that window take effect on January 1. If you enroll in a Medicare Advantage plan and change your mind, there is also a Medicare Advantage Open Enrollment Period from January 1 through March 31.
What you can change
Annual Enrollment is broader than most people expect. During this window you can:
- Switch from Original Medicare to a Medicare Advantage plan
- Switch from a Medicare Advantage plan back to Original Medicare
- Move from one Medicare Advantage plan to another
- Join, drop, or change a Part D prescription drug plan
A simple fall review checklist
Before you decide whether to keep or change your plan, look at the Annual Notice of Change your carrier mails in September and compare it against how you actually used your coverage this year.
- Confirm every prescription you take is still on the plan formulary and check its tier
- Confirm your primary care doctor and any specialists are still in network
- Compare your total expected cost, meaning premium plus copays plus deductibles, not premium alone
- Review extras you actually use such as dental, vision, hearing, or transportation benefits
- Note any planned procedures or new diagnoses that could change what you need next year
What happens if you do nothing
If you take no action, most plans renew automatically with whatever changes the carrier announced for the new year. That is sometimes the right outcome. It is only a problem when the plan changed in a way that no longer fits your medications or your doctors, and nobody checked.
FAQ
Common questions
Can I change Medicare plans outside of Annual Enrollment?
Sometimes. Special Enrollment Periods exist for situations such as moving to a new service area, losing employer coverage, qualifying for Extra Help, or gaining Medicaid eligibility. A licensed agent can tell you quickly whether you qualify.
Does reviewing my plan cost anything?
No. A plan review with Seniors Primero is free and there is no obligation to change anything. Many of our reviews end with the client keeping the plan they already have.
What is the Annual Notice of Change?
It is the document your plan mails in the fall that lists next year's premium, copays, formulary, and benefit changes. It is the single most useful page to read before deciding whether to stay or switch.
Keep reading
Have questions about your own situation?
Talk with a licensed Seniors Primero agent by phone. The conversation is free, there is no obligation, and we explain everything in plain language.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.