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Get Ready for 2026: It's Time to Review Your Medicare Coverage

 

Medicare Open Enrollment October 15th-December 7th.

Medicare's Annual Enrollment Period (AEP) is just around the corner, running from October 15 to December 7. This is your chance to review your current health and prescription drug coverage and make changes for the upcoming year. While it's easy to stick with the same plan, doing a yearly check-up on your coverage is crucial. Plans change, your health needs evolve, and new options become available every year.

Here's why you should take a close look at your Medicare plan for 2026 and who should be at the top of the list to review their options.

Why You Should Review Your Medicare Plan

Think of AEP as your annual open-book exam for your health. Your current plan may have been perfect for 2025, but a new year brings new variables.

1. Plan Changes Are Common: Insurance companies often adjust their offerings. A plan that worked for you this year may have a different premium, a new list of covered drugs (formulary), or a different network of doctors and hospitals in 2026. A medication that was once covered might no longer be, or its cost may have increased.

2. Your Health Needs May Have Changed: Did you start a new medication in 2025? Have you been diagnosed with a new condition or are you expecting a surgery in the coming year? Your current plan might not offer the best coverage for your new circumstances. A different plan could provide better benefits or lower out-of-pocket costs for the care you need.

3. New Plans and Benefits are Available: Every year, new Medicare Advantage and Part D plans are introduced. These new options may offer enhanced benefits, like dental, vision, or gym memberships, that weren't available in your area before. You could find a plan that not only saves you money but also provides more comprehensive coverage.

Who Absolutely Needs to Review Their Coverage for 2026?

While everyone with Medicare should take a few moments to review their plan, here are some groups that should make it a priority:

  • You Have a Medicare Advantage (Part C) Plan: If you're on a Medicare Advantage plan, it's essential to review it. Premiums, copays, deductibles, and doctor networks can all change. Be on the lookout for a "Plan Annual Notice of Change" (ANOC) from your carrier, which outlines all the upcoming changes.

  • You're Taking New or Expensive Medications: This is especially important if you're on a Part D prescription drug plan. A plan's formulary can change, and your current medications may not be on the list for 2026, or they may have moved to a different tier with a higher cost. With new caps on out-of-pocket costs for prescription drugs under Part D at $2,100 starting in 2026, it's a great time to evaluate your options to find a plan that offers the best value for your specific prescriptions.

  • Your Doctor is Leaving Your Plan’s Network: Doctor and hospital networks can change from year to year. If your primary care physician or a specialist you see regularly is no longer in your plan's network, you may face higher out-of-pocket costs or have to switch doctors.

  • You’ve Experienced Major Health Events in 2025: If you've had a surgery, been hospitalized, or received a new diagnosis, the plan that served you well before may not be the most cost-effective option for your future health needs.

  • You Want to Switch from Original Medicare to a Medicare Advantage Plan (or vice versa): AEP is the primary time to make this significant change. If you've been on Original Medicare and want the added benefits of a Medicare Advantage plan, or if you're ready to switch back to Original Medicare, this is your chance.

Don't Go It Alone - Get Expert Help

Navigating the world of Medicare can be confusing, with countless plans and options available. That's where I come in. As an independent Medicare broker, I work for you, not an insurance company. My goal is to help you compare plans, understand the changes for 2026, and find the coverage that best fits your unique health needs and budget.

The Annual Enrollment Period begins October 15 and ends December 7. Don't wait until the last minute. Let's get a head start on reviewing your options so you can enter 2026 with confidence in your coverage. Contact me today to schedule a free, no-obligation consultation.

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