Medicare coverage can change from one year to the next—and so can your healthcare needs. The Medicare Annual Enrollment Period gives eligible beneficiaries an opportunity to review their current coverage and make changes for the coming year.
Also known as Medicare Open Enrollment or AEP, this period runs from October 15 through December 7 each year. Coverage changes made during AEP generally take effect on January 1 of the following year.
At Adams Health Insurance Services, we help individuals in Camarillo, Ventura County, and surrounding California communities understand their Medicare options and determine whether their current coverage still fits their needs.
What Is the Medicare Annual Enrollment Period?
The Medicare Annual Enrollment Period is the time each fall when people who are already enrolled in Medicare can make certain changes to their health and prescription drug coverage.
During AEP, you may be able to:
- Switch from Original Medicare to a Medicare Advantage plan.
- Switch from a Medicare Advantage plan back to Original Medicare.
- Change from one Medicare Advantage plan to another.
- Enroll in, change, or drop a Medicare Part D prescription drug plan.
- Change to a Medicare Advantage plan with or without prescription drug coverage.
You are not required to change plans during AEP. However, reviewing your coverage is important—even if you have been happy with your current plan.
Why Should You Review Your Medicare Coverage Every Year?
Medicare Advantage and Part D plans can make annual changes to their premiums, deductibles, copayments, provider networks, pharmacy networks, formularies, and additional benefits. Your personal circumstances may also have changed during the year.
A yearly Medicare plan review can help you determine whether:
- Your doctors and preferred hospitals are still in the plan’s network.
- Your prescriptions remain covered by the plan’s formulary.
- Your medications have moved to a different pricing tier.
- Your preferred pharmacy is still considered in-network or preferred.
- Your premiums, deductibles, copayments, or maximum out-of-pocket costs have changed.
- Your dental, vision, hearing, transportation, fitness, or other benefits have changed.
- A different plan may better match your current healthcare needs and budget.
Even a small change to a drug tier, pharmacy status, or provider network can affect your costs and access to care.
Review Your Annual Notice of Change
If you are enrolled in a Medicare Advantage or Medicare Part D plan, your plan generally sends an Annual Notice of Change, commonly called an ANOC. This document explains changes to your plan’s coverage, costs, and service area for the upcoming year.
Do not set this notice aside. Compare the upcoming-year information with your current benefits and pay close attention to:
- Monthly premiums and deductibles
- Copayments and coinsurance
- Prescription drug coverage and pricing tiers
- Provider and pharmacy network rules
- Prior authorization requirements
- Additional benefits and coverage limitations
If anything is unclear, a licensed Medicare insurance agent can help you review the information and compare available options.
What Should You Bring to a Medicare Plan Review?
Preparing a few details ahead of time can make your appointment more productive. Consider bringing:
- Your Medicare card
- A complete list of prescriptions, including dosage and frequency
- The names of your preferred doctors, specialists, hospitals, and pharmacies
- Your current Medicare plan information
- Your Annual Notice of Change
- A list of questions or coverage concerns
This information helps your agent evaluate plan networks, prescription coverage, estimated costs, and benefits based on your individual needs.
AEP Is Not the Same as Medigap Open Enrollment
The Medicare Annual Enrollment Period is often confused with the Medicare Supplement, or Medigap, Open Enrollment Period—but they are not the same.
AEP primarily applies to Medicare Advantage and Medicare prescription drug coverage. Your federal Medigap Open Enrollment Period is generally a one-time, six-month period that begins when you are age 65 or older and enrolled in Medicare Part B. Outside that window, changing or purchasing a Medicare Supplement policy may involve medical underwriting unless you qualify for a guaranteed-issue right. Rules and availability can vary by state and individual circumstance.
Before leaving a Medicare Advantage plan for Original Medicare, speak with a licensed agent about your options. Returning to Original Medicare does not necessarily guarantee that you will qualify for the Medicare Supplement policy you want.
Avoid These Common Medicare AEP Mistakes
When reviewing Medicare coverage, try to avoid these common mistakes:
Choosing a plan based only on the premium
A low or $0 plan premium does not mean your total healthcare costs will be zero. Review deductibles, copayments, coinsurance, prescription costs, network restrictions, and the plan’s maximum out-of-pocket limit.
Assuming your doctors will remain in-network
Provider networks can change. Confirm participation directly with the plan and your healthcare providers before enrolling.
Forgetting to review prescription coverage
Each plan has its own formulary, pricing tiers, pharmacy network, and coverage requirements. Make sure every prescription is reviewed carefully.
Waiting until December 7
Waiting until the final day can create unnecessary stress and leave little time to ask questions. Begin reviewing your options early enough to make a careful, informed decision.
Assuming last year’s plan is still the right fit
Your plan may have changed, and your healthcare needs may have changed too. An annual review can help you avoid surprises in the new year.
Get Help With Your Medicare Options
Medicare plan comparisons can feel overwhelming, but you do not have to sort through the details alone. Adams Health Insurance Services provides personalized guidance to help you understand your Medicare coverage choices.
We can help you:
- Review your current Medicare coverage.
- Compare available Medicare Advantage and Part D plans.
- Check prescription drug coverage and estimated costs.
- Review provider and pharmacy networks.
- Understand plan benefits, costs, and limitations.
- Complete enrollment when you are ready to make a change.
Our goal is to provide clear information so you can make a confident, informed decision about your healthcare coverage.
Schedule Your Medicare AEP Review
The Medicare Annual Enrollment Period lasts from October 15 through December 7. Contact Adams Health Insurance Services to schedule your Medicare plan review and explore the coverage options available in your area.
Call 805-427-8400 to get started.
This information is intended for educational purposes and does not constitute a complete description of Medicare benefits or plan options. Plan availability, benefits, costs, provider networks, and formularies vary by plan and service area and may change each year. Contact Medicare, the plan, or a licensed insurance agent for complete details.