50plus Magazine
Medicare Guide 2026

A Healthy Plan Equals a Healthy You – Annual OEP goes beyond Enrollment

50Plus Magazine

Julie VanDyke

 

For those already enrolled in Medicare — for one or many years, the annual Open Enrollment Period (OEP) goes beyond enrollment.

 

While many breathe a sigh of relief once they’re enrolled, considering it a “one and done,” those aware the OEP is also an opportunity to review their plan stay ahead of the game. This because new offerings and discounts, plus changes in premiums and even in-network options, change. Often year by year, health needs change, too.

 

What May Change

Insurance companies may adjust monthly premiums, copayments, deductibles, or the list of covered medications (called a “formulary”). Your doctor or preferred hospital may no longer be in your plan’s network. Even small changes can add up over time, so a plan that worked for you this year might not be the best choice next year.

Doing an annual review can avoid surprises at the pharmacy or unexpected bills after a doctor visit. Reviewing the changes also gives you peace of mind knowing that your coverage still matches your health and financial needs.

 

What to Look for in Your Review

After receiving your Annual Notice of Change (ANOC — mailed in September), take a look at:

  • Premiums and Costs.

Is your monthly premium increasing? Are deductibles, out-of-pocket maximums or copayments changing?

  • Prescription Coverage.

Are your medications still covered? Are copayments changing?

  • Provider Networks.

Are your doctors and preferred specialists still in your plan’s network?

  • Extra Benefits. Some Medicare Advantage plans (Part C) may offer extras like dental, vision, hearing aids, fitness memberships, transportation, and more. Have any of these changed? Are there any new additions?
  • Coverage Needs. Have your health needs changed in the past year? If you’ve developed new conditions or need different medications, make sure your plan still fits.

 

Time Is of the Essence

Medicare’s OEP runs Oct 15-Dec 7 each year. During this time, you can:

  • Switch (or switch back) from Original Medicare (Parts A and B) to Medicare Advantage (Part C).
  • Change Medicare Advantage plans.
  • Enroll in, switch, or drop a Prescription Drug Plan (Part D).

 

Any changes you make during this period will become effective Jan 1 next year.

 

Tips for a Smooth Review

  • Gather Your Meds. Make a current list of all prescriptions, including dosage and frequency.
  • Check Preferred Pharmacies. Some plans offer better pricing at certain pharmacies. Many plans also offer convenient prescription home delivery services — check prices for this option.
  • Think Ahead. Consider not only your current health but also what may arise in the coming year.
  • Get Help. Overwhelmed? Get your questions answered with free personal assistance from a local agent. These folks are friendly, knowledgeable, and help free of charge.

 

Your Medicare coverage isn’t something to set and forget. A quick annual review helps you stay in control, ensuring your plan will continue to meet your health and financial needs. It’s your healthcare — it should work as hard for you as you worked to earn it.

 

I wonder how many would be better served if “Review” was added to the name of the Open Enrollment Period. Just a thought!

 

 

 

Julie VanDyke is a freelance writer specializing in retirement matters. She is committed to simplifying Medicare for all.