One of the questions I hear every year is, “Robin, I’ve had the same Medicare plan for years. Should I just keep it?”
The answer might not be that simple.
Keeping your current Medicare plan may absolutely be the right decision, but I never recommend making that decision without first reviewing your coverage. Every year, I encourage my clients to complete a Medicare plan review before their coverage automatically renews.
Even if your health has not changed, your Medicare plan might have. Premiums, provider networks, prescription drug formularies, deductibles, and plan benefits can all change from one year to the next. A yearly review helps determine whether your current plan continues to meet your healthcare and financial needs.
Why I Recommend Reviewing Medicare Coverage Annually
When people tell me they have been on the same Medicare plan for several years, I usually ask one question.
“When was the last time you compared it to the other plans available?”
Most people smile and admit it has been quite a while.
That is completely understandable. Once you find a plan that works well, it is easy to assume it will continue meeting your needs. However, Medicare coverage is not something I recommend putting on autopilot.
According to the Centers for Medicare & Medicaid Services (CMS), Medicare Advantage plans and Medicare Part D prescription drug plans may make changes each year to premiums, deductibles, provider networks, pharmacy networks, formularies, and supplemental benefits.
That means the plan you enrolled in several years ago may not look exactly the same today.
Your Healthcare May Change Even If You Feel Healthy
Many people believe they only need to compare Medicare plans after a major health event.
In reality, smaller changes can make a significant difference.
Perhaps you have started taking a new prescription medication.
Maybe you began seeing a specialist.
You may have changed primary care physicians or started using a different pharmacy.
Even changes in your retirement budget can affect which Medicare plan provides the greatest value.
Reviewing Medicare coverage annually allows you to compare your current needs with your current benefits rather than relying on last year’s assumptions.
What I Review With Every Client
When I sit down with someone during the Annual Enrollment Period, we take a comprehensive look at their coverage.
I want to understand how their plan performed over the past year and whether it continues meeting their expectations.
Some of the most important areas we review include:
Provider Networks
If you have a Medicare Advantage plan, I verify that your physicians, specialists, hospitals, and healthcare providers continue participating in your network.
Provider participation can change from year to year.
Checking this ahead of time helps prevent surprises when the new plan year begins.
Prescription Drug Coverage
Prescription drug costs often change even when your medications stay the same.
Insurance companies may update formularies, move medications into different pricing tiers, or change preferred pharmacy networks.
Reviewing your prescriptions during a Medicare plan review helps identify whether your current plan still offers competitive coverage.
Healthcare Costs
Monthly premiums tell only part of the story.
I also compare:
- Annual deductibles
- Copayments
- Coinsurance
- Prescription drug expenses
- Maximum out of pocket costs for Medicare Advantage plans
Looking at total expected annual healthcare expenses provides a much more complete comparison than evaluating premiums alone.
Supplemental Benefits
Many Medicare Advantage plans include benefits such as dental, vision, hearing, fitness memberships, transportation assistance, or allowances for certain over the counter products.
These benefits may change every year.
Reviewing them helps determine whether your plan continues providing the value you expect.
Review Your Annual Notice of Change
Every fall, your Medicare Advantage or Medicare Part D plan sends you an Annual Notice of Change, commonly called the ANOC.
According to CMS, this document explains the changes that will take effect for the upcoming plan year.
I always recommend reading it carefully.
It outlines updates involving premiums, deductibles, provider networks, prescription drug coverage, and other important plan features.
Your ANOC provides an excellent starting point for your Medicare plan review.
The Annual Enrollment Period Is Your Opportunity
The Medicare Annual Enrollment Period takes place each year from October 15 through December 7.
During this time, you have the opportunity to compare available Medicare plans and make changes if another option better fits your needs.
One thing I always emphasize is that reviewing your coverage does not mean changing your coverage.
In many cases, after reviewing all available options, my clients decide to keep the plan they already have.
That is a great outcome because it confirms they are still enrolled in a plan that supports their healthcare needs and financial goals.
When It May Be Time to Change Medicare Plans
Although many people remain with their existing coverage, there are situations where changing Medicare plans deserves careful consideration.
Some examples include:
- Your prescription medications have changed.
- Your healthcare providers are no longer participating in your network.
- Your healthcare costs have increased significantly.
- Your plan benefits have changed.
- You expect different healthcare needs in the coming year.
- Another available plan provides stronger overall value.
A careful Medicare plan review makes these comparisons much easier.
Avoid Automatic Renewals Without Reviewing
One of the most common mistakes I see is allowing Medicare coverage to renew automatically without reviewing available options.
Automatic renewal is convenient, but convenience should never replace an informed decision.
Healthcare needs change.
Insurance plans change.
Your financial priorities may change as well.
Taking just a little time each fall to review your Medicare coverage can help ensure your plan continues working for you rather than against you.
My Advice
When someone asks whether they should keep the Medicare plan they have had for years, my answer is simple.
Keep it if it still meets your needs.
Just do not assume that it does.
A yearly Medicare plan review gives you the opportunity to compare benefits, review healthcare costs, evaluate prescription drug coverage, and confirm your providers are still participating.
Sometimes the review leads to a better plan.
Sometimes it confirms your current plan remains the right choice.
Either way, you gain confidence knowing your decision is based on current information rather than habit.
If you are preparing for the Annual Enrollment Period and would like help reviewing your Medicare coverage, I would be happy to compare your options, explain any plan changes, and help you determine whether your current coverage continues to be the best fit. Contact us to get started.
