Don't 'Set It and Forget It': Why You Should Review Your Medicare Plan Every Year

As we navigate the complexities of healthcare, Medicare stands as a vital resource for millions of Americans. Many beneficiaries select a plan and then assume their coverage will remain the same year after year. However, this 'set it and forget it' approach can lead to unexpected costs or gaps in care as time goes on.

Medicare plans, whether they are Original Medicare with supplemental coverage (Medigap and Part D) or Medicare Advantage plans, can change annually. Your health needs also evolve. A proactive annual review is a simple yet powerful habit that can keep your healthcare coverage aligned with your life.

Plan Changes Can Affect Your Wallet and Well-being

Insurance companies offering Medicare Advantage and Part D plans can adjust their benefits, premiums, deductibles, co-pays, and formularies (lists of covered drugs) from one year to the next. For example, a Medicare Advantage plan might change its network of doctors or hospitals, meaning your trusted physician might no longer be 'in-network.' A Part D plan might remove a key medication you rely on from its formulary, or move it to a higher cost-sharing tier.

These changes aren't always negative, but they can have significant financial and health implications if you're not aware of them. Staying with a plan that no longer fits your needs could mean paying more for prescriptions, facing higher out-of-pocket costs for doctor visits, or even having to switch healthcare providers.

Your Health Needs Are Always Evolving

Beyond what your plan offers, consider what you need. Perhaps you've developed a new health condition that requires different medications or more frequent specialist visits. Maybe you're planning a move to a new state or a different part of your current state, which could impact your plan's network coverage.

Your current plan, which was a perfect fit last year, might not be the best option today. Taking stock of your recent health journey – doctor visits, prescriptions, and any anticipated health changes – is an essential part of an effective annual review.

When and How to Review Your Plan

The optimal time for this annual check-up is during the [Annual Enrollment](/enrollment) Period (AEP), which runs from October 15th to December 7th each year. During this window, you can make changes to your Medicare Advantage and Part D plans for the upcoming year, with coverage beginning on January 1st.

Here’s a simple process to guide your review:

1. Gather Your Current Plan Documents: Around September, your current plan provider will send you an "Annual Notice of Change" (ANOC). This document details all the upcoming changes to your plan for the next year. Read it carefully.
2. Assess Your Health Needs: Make a list of all your current medications, including dosages, and note any new doctors or specialists you've started seeing regularly.
3. Use Official Resources: Visit Medicare.gov's Plan Finder tool. This free, unbiased resource allows you to compare plans available in your area based on your specific medications and preferences. You can input your current prescriptions to see which Part D or Medicare Advantage plans cover them at the lowest cost.
4. Consider All Your Options: Don't just compare your current plan to itself; look at other plans available. A new plan might offer better benefits or lower costs for your specific situation.

This yearly review isn't just about saving money; it's about ensuring peace of mind and access to the care you need. Taking this small step annually can make a big difference in managing your health and finances as you age.