Medicare coverage
Should I Keep My Medicare Plan or Switch During AEP?
You do not need to change your Medicare plan just because it is enrollment season. But you should understand whether it will still meet your needs next year.
Medicare’s Annual Enrollment Period, also called fall Open Enrollment, runs from October 15 through December 7. Changes made during this period generally take effect January 1. It is an opportunity to review Medicare Advantage and Part D coverage and make permitted changes.
Start with what is changing
Find your plan’s Annual Notice of Change and review it alongside your current experience.
Have your medications changed? Are you seeing a new specialist? Did you struggle with referrals, authorizations, or unexpected bills? Those details belong in your plan review.
Compare the features you actually use
A useful review should address:
- Doctors and hospitals: Check participation in the exact plan.
- Prescriptions: Review your medications, dosages, pharmacy, and estimated annual drug costs.
- Medical expenses: Compare office visits, hospital care, outpatient procedures, and other services you may need.
- Coverage rules: Understand referrals, prior authorization, and out-of-network restrictions.
- Extra benefits: Check limits and eligibility requirements instead of relying on an advertised headline.
Medicare recommends reviewing premiums, deductibles, and estimated yearly prescription costs when choosing coverage.
When might keeping your plan make sense?
Keeping it may be reasonable if it remains available, your providers and medications are covered appropriately, and its costs and rules still fit your needs.
Switching deserves consideration when a meaningful change affects your access to care or your budget. A neighbor’s favorite plan may not fit your doctors, medications, or health conditions.
Be careful when considering a Medicare Supplement
AEP is not a universal guaranteed-acceptance period for Medicare Supplement insurance, also called Medigap.
If you are considering leaving Medicare Advantage for Original Medicare and purchasing a supplement, check your Medigap eligibility first. Outside protected enrollment situations, an insurer may use medical underwriting, and acceptance is not guaranteed.
Make the decision around your needs
Bring your current plan information, doctors’ names, medication list, and questions to your review.
Contact Simply Health Insurance Agency at simplyhealthinsurance.net to review your Medicare coverage and decide whether keeping or changing your plan makes sense for you.