Why You Must Check Your Coverage

Every year, from October 15th to December 7th, Medicare beneficiaries have the opportunity to make changes to their Medicare Advantage and Prescription Drug Plans during the Annual Enrollment Period (AEP). While it may be tempting to simply keep your current plan if you've been satisfied, ignoring this window could lead to unexpected costs and gaps in your coverage next year.

The AEP isn't just for switching plans—it's your chance to perform a critical annual health check-up for your insurance.

Why an Annual Review is Essential

Private Medicare plans, including Medicare Advantage (Part C) and Prescription Drug Plans (Part D), are not static. The benefits and costs you relied on this year can—and often do—change for the upcoming year.

Here are the key factors that change annually, making a review necessary:

1. Formulary (Drug List) Changes: Every Part D plan has a formulary, or a list of covered drugs. A drug you rely on might move to a higher cost-sharing tier, or it could be dropped from the plan entirely. Reviewing the new formulary is crucial to ensuring your prescriptions remain affordable.

2. Cost and Premium Adjustments: Plans often adjust their premiums, deductibles, and co-pays. An increase in these out-of-pocket costs could significantly impact your retirement budget.

3. Network Changes: If you are enrolled in a Medicare Advantage HMO or PPO, your plan's network of doctors and hospitals may change. Your trusted primary care physician or specialist might leave the network. Reviewing the provider directory is essential to confirm your favorite doctors will still be in-network next year.

4. New Benefits and Options: Insurance carriers frequently introduce new plans or enhance existing benefits, such as expanded dental, vision, or fitness programs. Reviewing the landscape allows you to see if a different plan offers superior value or better addresses a new health need.

The Agent's Role: Your Review Partner

Navigating the multitude of Annual Notice of Change (ANOC) documents, Summary of Benefits sheets, and new plan details can be overwhelming. This is where a local, licensed agent is your most valuable resource.

We are certified to understand the upcoming year's changes across multiple carriers and can simplify the review process by:

• Comparing Drug Costs: We can run your specific list of prescriptions against all available plan formularies to identify the most cost-effective option for your medications.

• Checking Provider Networks: We confirm that your current doctors are still in-network with your existing plan or any new plans you are considering.

• Providing Unbiased Facts: As independent agents, our focus is on providing factual, neutral comparisons of the options available in your local area, so you can make a clear decision about whether to stay put or make a compliant change.

Don't wait until you get your first bill in January to realize your plan changed. Use the AEP—October 15th to December 7th—to actively manage your healthcare security.