Every fall, a stack of mail shows up with thick envelopes, bold print, and phrases like "important plan information." It's easy to set it aside. Please don't. Medicare's Annual Enrollment Period runs October 15 to December 7, and whatever you choose in that window takes effect January 1. The best time to get ready is right now, before the window opens and the TV ads start up.
Here's what's worth reviewing, in the order I'd tackle it.
1. Read your Annual Notice of Change
If you have a Medicare Advantage plan or a Part D prescription drug plan, your insurer is required to send you an Annual Notice of Change (ANOC) by the end of September. This is the single most useful document you'll receive all year. It spells out what is different about your plan for next year: premiums, deductibles, copays, drug coverage, and which doctors and pharmacies are in the network.
Plans change every year, even when you've been happy with yours. A drug that was covered last year may move to a higher cost tier, or drop off the list entirely. If you only read one thing, make it this.
2. Check your medications, one by one
Make a list of every prescription you take, including the dose and how often you take it. Then check each one against next year's plan formulary (the list of covered drugs). Look at three things:
- Is the drug still covered?
- What tier is it in, and what will you pay?
- Does your plan require prior authorization or step therapy for it?
Also confirm that your pharmacy is still in the plan's network, and whether it counts as "preferred." Using a preferred pharmacy can lower your costs.
3. Confirm your doctors and hospitals are still in network
This matters most for Medicare Advantage plans, which use provider networks. Call your primary care doctor and each specialist you see, and ask directly whether they will accept your plan in the new year. Don't rely only on the insurer's online directory, since those can be out of date. If you have a hospital you'd want to use in an emergency, check that one too.
4. Look at the total cost, not just the premium
A low monthly premium can be misleading. Add up what you could realistically spend in a year:
- Monthly premium
- Deductible
- Copays and coinsurance for doctor visits, specialists, and tests
- Drug costs
- The plan's maximum out-of-pocket limit (Medicare Advantage plans have one; Original Medicare does not)
If you had a health event this year, run those real numbers through next year's plan. It's the best way to see how it would have worked for you.
5. Think about how your health has changed
Your needs this year may not match what they were a year ago. Did you start a new medication, see a new specialist, or have a procedure? Do you expect surgery, physical therapy, or regular testing in the coming year? Choose a plan for the life you have now, not the one you had when you first enrolled.
6. Know what your options are
During open enrollment, you can generally:
- Switch from Original Medicare to a Medicare Advantage plan, or the other way around
- Change from one Medicare Advantage plan to another
- Join, switch, or drop a Part D drug plan
A few things to keep in mind. If you're in a Medicare Advantage plan, there's also a separate Medicare Advantage Open Enrollment Period from January 1 to March 31, which lets you switch plans or return to Original Medicare. If you're thinking of leaving Original Medicare for Advantage (or the other way around), look into how a Medigap supplement policy would work. Rules for buying one differ by state and by when you apply, so ask before you make a change you can't easily undo.
If you like your plan and the notice shows nothing that worries you, you don't have to do anything. Your coverage will simply renew.
7. Watch out for scams and pushy sales calls
Open enrollment season brings a wave of unsolicited calls, mailers, and "free gift" offers. A few rules of thumb:
- Medicare will not call you out of the blue to sell you something or ask for your Medicare number.
- Never give your Medicare, Social Security, or bank information to someone who contacted you first.
- Take your time. There's no legitimate reason to decide on the spot.
8. Get free, unbiased help
You don't have to figure this out alone. Here are good places to start:
- Medicare.gov Plan Finder: compare plans in your area using your actual medications and pharmacies.
- 1-800-MEDICARE: speak with someone directly about your coverage.
- Your state's SHIP program: trained counselors give free, unbiased help. In New York, that's HIICAP, available through your county Office for the Aging.
- A licensed, independent broker: they can be useful too, but remember that they may earn commission, so ask which plans they can and can't offer.
A simple plan for the next two weeks
- Find your Annual Notice of Change and read it this week.
- Write down your medications and your doctors.
- Check each against next year's plan.
- Compare at least one or two alternatives on Medicare.gov.
- Book a free counseling appointment if anything feels unclear.
Then, once October 15 arrives, you can make your decision calmly instead of rushing. Medicare can feel complicated, but a little preparation goes a long way, and most people feel much better once they've checked the details for themselves.
FAQ
When is Medicare open enrollment?
The Annual Enrollment Period runs October 15 to December 7 each year, and changes take effect January 1.
What should I review before Medicare open enrollment?
Start with your Annual Notice of Change, then check your medications, doctors, total yearly costs, and whether your health needs have changed.
Do I have to do anything if I'm happy with my plan?
No. If you don't make a change, your coverage will generally renew for the next year, though it's still smart to read your notice first.
**This article is for general information and isn't personal insurance or financial advice. Plan details vary, so always confirm your own coverage with Medicare or your plan.
