The Medicare Annual Enrollment Period (AEP) is a crucial time for beneficiaries to review and adjust their Medicare coverage. Held from Oct. 15 to Dec. 7 each year, this window provides an opportunity for you to make changes to your Medicare plans, ensuring your plans align with your healthcare needs for the upcoming year. Whether you’re new to Medicare or already enrolled, understanding how to maximize your benefits during AEP is essential.
Understanding the Annual Enrollment Period
AEP allows beneficiaries to switch between Medicare Advantage plans, move from Original Medicare (Parts A and B) to Medicare Advantage, or change their prescription drug plan (Part D). These adjustments can be made based on changes in health, finances, or coverage needs. During AEP, your goal is to ensure your Medicare plan matches your healthcare requirements and budget. Learn more about Medicare plan options.
If your current plan no longer fits your needs, AEP is the time to explore alternatives. Each year, new plans become available, and existing plan details such as premiums, co-pays, and coverage specifics can change, making it important to evaluate your options annually. Get a detailed look at AEP from Medicare.gov.
Reviewing Changes in Your Current Plan
Start by reviewing the "Annual Notice of Change" from your Medicare plan provider, if you have a Medicare Advantage or Part D plan. This document outlines any changes to your coverage, costs, or the provider network, including whether your doctors and hospitals are still in-network. Sometimes, a plan may no longer cover services or medications you need, so reviewing these changes is essential to avoid unexpected costs in the coming year. Review your Medicare coverage details.
Additionally, assess any changes in your health. If you’ve started taking new medications or require more specialized care, make sure your Medicare plan reflects your current situation, rather than relying on what worked in the past.
Comparing Medicare Plans
Medicare provides a Plan Finder tool on its website to help you compare Medicare Advantage and Part D plans available in your area. This tool allows you to filter by zip code and review plan details such as drug coverage, costs, and additional benefits like vision, dental, and wellness programs. Use the Medicare Plan Finder to compare plans.
When comparing plans, consider:
- Monthly premiums and out-of-pocket costs
- Prescription drug coverage, especially if your medications have changed
- Provider networks to ensure your preferred doctors are included
- Additional benefits such as vision, dental, or hearing coverage
Selecting the right plan can help you save money and ensure your healthcare needs are met without surprises.
Prescription Drug Coverage Considerations
Prescription drug costs can significantly impact your healthcare budget. During AEP, review your Medicare Part D plan to confirm it covers the medications you need. Medicare Part D plans often change their formulary—the list of covered drugs—each year, potentially affecting your out-of-pocket costs. If your medication needs have changed, you may need to switch plans to maintain coverage or find a more affordable option. Learn about Medicare Part D prescription coverage.
It’s also important to consider the coverage gap, commonly known as the "donut hole," in Medicare Part D. This gap occurs after your drug costs reach a certain limit, resulting in higher out-of-pocket costs. Some Part D plans offer additional coverage during this period, which can be beneficial if you anticipate high prescription costs.
Working with a Medicare Counselor or Advisor
If reviewing and comparing plans feels overwhelming, free counseling services such as your State Health Insurance Assistance Program (SHIP) can help. SHIP counselors provide unbiased guidance, helping you understand your options and select the best plan for your needs. Find SHIP assistance in your state.
Additionally, many Medicare Advantage and Part D plan providers offer online resources and customer service representatives to assist with plan comparisons. To help you navigate these options and find the best plan for your needs, we’ve teamed up with Chapter to provide personalized, 1-1 guidance.
Taking Action Before the Deadline
The AEP window runs from Oct. 15 to Dec. 7 each year. If you don’t make changes during this period, you’ll generally remain in your current plan for the next year unless you qualify for a Special Enrollment Period.
By carefully reviewing your options and making informed decisions, you can maximize your Medicare benefits for the upcoming year. Don’t wait until the last minute—take the time to research, compare, and adjust your plan before the deadline.
The Medicare Annual Enrollment Period is your chance to align your coverage with your healthcare needs and budget. To help you navigate AEP, GetSetUp offers Medicare classes to guide you through plan comparisons, coverage options, and maximizing your benefits. Join us today and take control of your Medicare plan for the upcoming year.
Reviewed By: Keith Gilbert