7 Essential Steps After You Enroll

As a teacher of 30 years, I love to explain things, and nothing is more important than understanding your healthcare. Congratulations on enrolling in your 2026 Medicare plan! Now that Annual Enrollment is over and you have your new plan in hand, what should you do next?

A successful plan year starts with a few key organizational steps. Follow this 7-step guide to ensure a smooth transition into your new benefits for the year ahead.

Need Personalized Help? Local agents are your greatest resource. You can see my previous post about why a local agent matters here: Your 2026 Medicare Journey: Why a Local Agent Matters. Contact me if you have any questions or would like help finding an agent near you.

1. Join Your Provider's Member Portal

This is your personal hub for managing your healthcare. After your plan starts, find the web address for your provider's portal (often linked on their website) and create an account. Here, you can typically follow your claims, review your Explanation of Benefits (EOB), and track how you're utilizing your plan's benefits.

2. Understand Your Explanation of Benefits (EOB)

Do not pay anything other than your known copay until you receive your official Explanation of Benefits (EOB) from your plan at the end of the month.

When you first visit a provider in the new year, your new card needs to be billed. Call the provider’s office to ensure they have updated their system and billed the correct card for the new year.

Crucial Advice: Open everything! Do not throw any mail away that comes from your plan or your providers. These documents often contain vital information about your costs, coverage, or appeals.

3. Get the Provider App & Check for Extra Benefits

Many plans offer a member-facing app. Download it! These apps often allow you to access a digital ID card, find network doctors, and track your wellness.

P.S.: You might be able to receive extra benefits or rewards by completing challenges hosted in the app, such as a walk-a-thon, filling out a health risk assessment form, or getting your annual physical. These extra perks are a great way to earn points or gift cards while staying healthy.

4. Check Your Prescriptions in the Plan Formulary

Even if you checked your medication during enrollment, it's essential to check the plan's formulary (list of covered drugs) one more time at the start of the year. If a medication you need is not on your plan's formulary, let your doctor know immediately. Your doctor can often send a letter to your provider to request an exception or prior authorization to get your medication approved for coverage.

5. Confirm Coverage for All Specialists and Services

Before scheduling an appointment, especially with specialists, ensure that they are still covered under your new plan's network. Also, be proactive about checking for prior approval requirements. Some services, treatments, or specialist visits require the insurance company to approve them before you receive the care. A quick call to your plan or a check of the portal can save you from an unexpected bill.

Extra Help: Limited Income Subsidy

If you have limited income and resources, you may qualify for the federal program "Extra Help" (also known as the Low-Income Subsidy or LIS) to help pay for Medicare prescription drug costs.

You may qualify if you make less than $23,475 as a single person or $31,725 as a couple (Note: These are the standard 2025 income limits, and 2026 limits may be slightly higher once finalized by Social Security).

To apply for this limited income subsidy, visit the official government website and go to the Extra Help section: ssa.gov.

6. Schedule Your Annual Wellness Visit

This is Step 6, but it’s one of the most important! Get your annual exam right away—you can often put this on your provider app and receive points or rewards.

Key Difference: The Medicare Annual Wellness Visit (AWV) is not a normal doctor's check-up. The AWV is an annual appointment with your primary care provider to:

• Develop or update a personalized prevention plan.

• Review your medical history, health risks, and current medications.

• Create a screening schedule (like cancer screenings).

It is a conversation focused on prevention, risk assessment, and long-term health planning—it does not involve blood work or a physical body examination.

7. Create a Designated Medicare Folder

I send a folder to all of my customers, but you can purchase a normal folder from any store. Put everything you receive from your provider in here, including any important emails you print out.

The most important document you will receive is the Annual Notice of Change (ANOC). This document tells you exactly what is going to be covered in 2026 that is different from 2025. By filing it away, you ensure you can reference it when needed.

Following these seven steps will help you take control of your Medicare coverage and maximize your benefits throughout the entire year.

Ready to find the right plan for 2026? Contact Taylor Your Insurance today!

Contact Taylor Your Insurance

Disclaimer: I am an independently licensed insurance agent. I do not represent all insurance plans available in your area. Information in this post is for educational purposes only. Enrollment in a plan is dependent on contract renewal.