.png)
Essential Steps to Review Your Coverage
- Dreamers Design LLC
- Oct 14
- 3 min read
Hello everyone! I'm Linda Taylor, owner of Taylor Your Insurance. I'm excited to announce that I will be continuing my educational Facebook Live events every Tuesday at 12:00 pm CDT throughout this Annual Enrollment Period and beyond. With my background—30 years as a teacher and 15 years as a Medicare professional—my primary goal is always to educate you on your Medicare options so you can make an informed choice.
The Annual Enrollment Period (AEP) is here, and it is the most critical time for us to review your Medicare coverage. Even if you love your current plan, I can tell you from experience that benefit and cost changes for the upcoming year are very common. Let’s review the core questions to ask yourself and me, your agent.
1. Are You Eligible for Medicare?
Generally, you become eligible for Medicare when you turn 65. However, there are other paths to enrollment that I can help you with:
If you have been receiving Social Security Disability benefits for 24 months, you may be eligible.
If you experience a qualifying life event, such as losing your employer group coverage, you may qualify for a Special Enrollment Period (SEP) to enroll outside of AEP.
You can learn more and apply for Medicare Part A and Part B at SSA.gov.
2. Should You Keep Your Group Plan or Start Medicare?
This is one of the most common and complex questions I get, and the answer varies greatly based on your personal and financial situation. When we compare your employer’s group health insurance to Medicare, we need to consider:
Dependents: Do you have a spouse or children covered by your group plan? If so, you may need to keep that plan, as Medicare does not cover dependents.
Premiums & Coverage: Is your group plan’s premium very low? Does the coverage meet your specific needs?
Health Savings Accounts (HSAs): If you are contributing to an HSA, you must stop contributing once you enroll in any part of Medicare (including premium-free Part A).
I am always happy to provide a no-obligation, 10-minute consultation to help you compare your current group coverage to your potential Medicare options side-by-side.
3. My 2026 Medicare Plan Review Checklist
Your health plan carrier mails you an Annual Notice of Change (ANOC) every September. This document details all changes for the upcoming year, and I encourage you to review it carefully. Here are the key questions I want you to ask me about any new or existing plan:
Costs: What are the monthly premiums, copayments, and the maximum out-of-pocket (MOOP) limit? I look closely at annual adjustments to costs to confirm the plan remains affordable. (Note: The MOOP for Medicare Part D is changing for 2026).
Provider Network: Are your current doctors and hospitals in-network? Is the plan an HMO or a PPO?
HMOs generally require you to stay in-network (except for emergencies).
PPOs allow you to see out-of-network providers, but at a higher cost share.
Prescriptions: Are all of your current medications still covered on the plan’s formulary, and how much will they cost you? Drug formularies change annually, which is why I can run a detailed cost comparison for your specific prescriptions.
Extra Benefits: What “extras” are included? Please ask me about dental, vision, hearing, and wellness benefits (like gym memberships/SilverSneakers). As medical costs rise, carriers sometimes adjust these benefits.
Emergency Needs: What are the copays for ground and air ambulance services? This is an important question, especially if you travel frequently, visit remote areas, or live in the country where air evacuation may be necessary.
4. Plan Quality and Assistance Programs
Star Ratings: Medicare assigns Star Ratings (1-5) to plans based on quality and performance. I recommend you always take a moment to look up your plan's Star Rating.
Financial Assistance: Do you qualify for Extra Help (Low-Income Subsidy) with your prescription drug costs, or for Medicaid? You can apply for Extra Help at SSA.gov.
The Value of an Experienced Agent
I truly believe that having a dedicated agent is invaluable. I always try my best to teach you what you need to know, as I did when I was a teacher. While I primarily operate virtually, I also encourage you to always get a local agent if you prefer that service—and if you don't have one, I can certainly help you find a trusted one in your area. You can read more about why this matters here: Your 2026 Medicare Journey: Why a Local Agent Matters.
Ready to find the right plan for 2026? Contact Taylor Your Insurance today!
Contact Taylor Your Insurance
Website | |
Phone | +1 573-578-5333 |
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.
Comments