Medicare Annual Enrollment: What to Check Before December 7
Each fall, people with Medicare get a chance to review their coverage and make changes for the year ahead. This yearly window is called the Annual Enrollment Period, and it runs from October 15 to December 7. Changes you make take effect on January 1.
You don’t have to change anything if your current coverage still meets your needs. But your medications, health needs or budget may have changed, and your plan’s costs and benefits may be changing, too.
Key dates
Your Medicare Advantage or Part D plan sends details about changes to next year’s costs, benefits and coverage.
The window begins to review plans and make changes.
The last day to make changes for the coming year.
Your changes take effect.
What you can do during Annual Enrollment
- Switch from Original Medicare to a Medicare Advantage plan, or the other way around.
- Change from one Medicare Advantage plan to another.
- Join, switch or drop a Medicare prescription drug (Part D) plan.
Rules differ depending on the type of coverage you have now, so confirm what applies to your situation. Official details are on Medicare.gov.
A note about Medicare Supplement insurance. If you’re thinking about leaving Medicare Advantage for Original Medicare, look into Medicare Supplement (Medigap) options before you make the change. Unlike Medicare Advantage and Part D plans, Medicare Supplement policies have different enrollment rules, and you may not always qualify for the coverage you want.
Start with the papers your plan sent
If you already have a Medicare Advantage or Part D plan, it should send you an Annual Notice of Change and an Evidence of Coverage each fall. They describe what’s changing for next year, such as costs, benefits and covered drugs. Check them for details about doctors and pharmacies, too. It’s easy to set these aside, so find them and read them first.
Matching what you want to what to review
| If you want to… | You might review |
|---|---|
| Keep your current coverage | Your Annual Notice of Change. If the changes work for you, you may not need to do anything. |
| Look at drug costs | Each plan’s list of covered drugs and which pharmacies it uses. |
| Keep your doctors or hospitals | Whether they’re in the plan’s network, before you switch. |
A checklist to work through
- Your medications. Are all of them still covered next year, and at what cost? Plans can change which drugs they cover and how much you pay.
- Your pharmacy. Is the pharmacy you use, such as your local Glenwood Springs pharmacy, still included, and are the costs the same there?
- Your doctors and hospitals. Are your local hospitals and the specialists you trust still in your plan’s network, if your plan has one?
- If you need care unexpectedly. Check how your plan handles urgent care, emergency services, referrals and specialists.
- Your costs. Look at monthly premiums, deductibles, copays and the yearly out-of-pocket limit, not just one of them.
- Where you spend your time. If you spend winters out of state, confirm how your plan handles care outside Colorado.
- Your health. Has anything changed, or do you expect new care next year? Think about what you may need.
- Your plan’s extras. If your plan offers extra benefits, check whether you use them, and whether they’re changing.
Where to get unbiased information
You don’t have to figure this out alone, and you shouldn’t feel pressured. Good places to start:
- Medicare.gov, including its plan comparison tool
- 1-800-MEDICARE (1-800-633-4227)
- Colorado’s State Health Insurance Assistance Program (SHIP), which offers free, unbiased counseling