Why You Should Review Your Medicare Plan Every Year

Medicare Coverage Isn't a "Set It and Forget It" Decision

A lot of people assume that once they choose a Medicare plan, that choice is final — the same way you might pick a bank and never think about it again. Medicare doesn't work that way. Plans are built, priced, and re-approved every single year, which means the plan that fit you perfectly last January can look meaningfully different by the time this January rolls around, even if you never lifted a finger.

That's not a flaw in the system — it's built in on purpose, which is exactly why Medicare gives you a dedicated window every fall to check in and make changes if you need to.

What Can Actually Change From Year to Year?

A handful of things quietly reset every January, whether or not you're paying attention:

• Prescription drug coverage. Formularies (the list of covered drugs) and their cost tiers can change, which means a medication that was cheap last year might jump in price — or drop off the list entirely.
• Provider networks. Doctors and hospitals move in and out of network agreements. The specialist you've seen for years isn't guaranteed to stay in-network indefinitely.
• Premiums, deductibles, and copays. Insurers reprice plans annually, and a plan that was affordable can get quietly more expensive.
• Extra benefits. Dental, vision, hearing, and fitness perks on Medicare Advantage plans are often the first things to shift from one plan year to the next.

None of this means your plan is doing something wrong. It means the landscape around your plan moves every year — so it's worth a look, even if nothing about your health has changed.

When Can You Actually Make Changes?

Annual Enrollment Period (AEP): October 15 – December 7

This is the big one. During AEP, you can switch Medicare Advantage plans, switch Part D prescription drug plans, move from Original Medicare into a Medicare Advantage plan, or move back from Medicare Advantage to Original Medicare. Whatever you choose takes effect January 1 of the following year.

Medicare Advantage Open Enrollment Period (MA OEP): January 1 – March 31

This second window is narrower — it's only for people already enrolled in a Medicare Advantage plan. If your AEP choice isn't working out once you actually start using it, MA OEP gives you one more chance to switch to a different Medicare Advantage plan or move back to Original Medicare.

Special Enrollment Periods (SEPs)

Outside these two windows, certain life events can open a Special Enrollment Period — moving out of your plan's service area, losing other creditable coverage, your plan leaving the Medicare program, or qualifying for Medicaid or Extra Help, among others.

What Should You Actually Check During Your Annual Review?

• Are your current prescriptions still on your plan's formulary, and at the same cost tier?
• Are your doctors, specialists, and preferred hospital still in-network?
• Has your premium, deductible, or out-of-pocket maximum changed for next year?
• Are there $0-premium or lower-cost plans now available in your area with better benefits?
• Has your health changed enough that a different plan type would genuinely serve you better?

Even a Good Plan Can Quietly Get Worse — or a Better One Can Show Up

If your plan has treated you well, that's not a reason to skip the review — it's exactly why the review is quick. Even when the answer is "stay put," you'll know that for certain instead of assuming it. And some years, the better move is one you'd have never found without checking: a lower premium, a newly in-network specialist, or a drug plan that finally covers what you actually take.