Quick Summary:
You do not have to change your Medicare coverage every year, but you should review it during the Medicare annual enrollment period. For 2026, the window runs from October 15 through December 7. A few focused checks—your doctors, prescriptions, costs, and plan rules—can help you decide whether keeping your current coverage or making a change is appropriate for January 1, 2027.
Medicare decisions can feel time-sensitive and complicated, especially when mailings, plan notices, and advertisements arrive all at once. A calm Medicare plan review starts with one simple question: does your current coverage still work for the care, medications, and budget you expect next year?
Know What the December 7 Deadline Means
The Medicare annual enrollment period, often called Medicare Open Enrollment, is October 15 through December 7 each year. During this time, people may make certain changes to Medicare health and drug coverage for the following year. Changes requested by December 7 generally take effect on January 1.
Depending on your current coverage, you may be able to change Medicare Advantage plans, move from Medicare Advantage to Original Medicare, move from Original Medicare to Medicare Advantage, or make changes to Medicare Part D prescription drug coverage. The options available can depend on the coverage you have now and your individual circumstances.
The key point: reviewing your plan does not obligate you to change it. If your current coverage continues to fit your needs, you may decide to keep it. But waiting until after December 7 can limit the changes you can make for the next plan year.
Start With Your Annual Notice of Change
If you are enrolled in a Medicare plan, your plan sends an Annual Notice of Change
each fall. This notice explains changes that may apply in the coming year. Set aside time to read it rather than filing it away with other mail.
Look for changes involving your monthly plan premium, deductible, copayments, coinsurance, prescription drug coverage, pharmacy network, provider network, and benefits or service rules. A plan that fit well this year may operate differently next year, even if its name remains the same.
As you review the notice, make a short list of anything that changed and anything you do not understand. That list becomes a practical starting point for a Medicare plan comparison.
Check Whether Your Doctors and Care Providers Still Fit
Your relationship with doctors, specialists, hospitals, and other providers matters. If you are considering a Medicare Advantage plan review, confirm that the providers you want to use are included in the plan’s network for the coming year and understand the plan’s rules for referrals or prior authorization where applicable.
Also think about the care you expect to need. Have you started seeing a new specialist? Do you anticipate a procedure, therapy, or ongoing treatment? Have you moved or expect to spend part of the year elsewhere? These changes can affect whether your current plan remains a good practical fit.
Do not rely on last year’s provider participation. Networks and plan rules can change, so verify current information directly before enrolling in a new plan.
Review Every Prescription and Pharmacy Choice
Prescription coverage deserves a fresh review every year. Medicare Part D changes may affect which drugs are covered, which coverage tier applies, whether prior authorization or other requirements apply, and what you may pay at the pharmacy.
Create an up-to-date medication list that includes drug names, dosage, frequency, and the pharmacies you prefer to use. Then compare that list against your current coverage and any alternatives you are considering. A plan comparison is most useful when it reflects the medications you actually take—not an outdated list from last year.
If you use a Medicare Advantage plan that includes prescription drug coverage, review both the medical and drug portions together. If you use Original Medicare with a stand-alone Part D plan, review the drug plan separately while considering how it works alongside your other coverage.
Compare the Full Cost Picture, Not Just One Number
A low monthly premium is only one part of a Medicare plan review. Consider the full picture, including deductibles, copayments, coinsurance, out-of-pocket limits, drug costs, provider and pharmacy rules, and coverage for the services you use most often.
It can help to write down what you spent this year on routine visits, specialists, prescriptions, testing, and other care. While no one can predict every health need, looking at your real use of care can make the comparison more meaningful.
Focus on understanding tradeoffs rather than looking for a one-size-fits-all answer. The plan that appears simplest at first glance may not be the plan that aligns best with your doctors, medications, and anticipated care.
When It May Be Time to Change Your Medicare Advantage Plan
You may want to explore a change if your plan’s provider network no longer includes an important doctor or facility, your prescriptions are handled differently, your costs or plan rules have changed, or your health needs have shifted. A move to a new service area or a change in other coverage can also be worth discussing.
Changing coverage is a significant decision, so give yourself enough time to compare options carefully before December 7. Keep records of the information you review and ask questions about how any change may affect your access to care and prescription drugs.
A Simple Medicare Plan Review Checklist
- Read your Annual Notice of Change.
- List your doctors, specialists, hospitals, and preferred pharmacies.
- Update your prescription list with names and dosages.
- Review premiums, deductibles, copayments, coinsurance, and plan limits.
- Confirm provider and pharmacy participation for the coming year.
- Compare Medicare plan options based on your own care and medication needs.
- Complete any enrollment request by December 7 if you decide to make a change.
At Insurance and Benefits Resource Group, we believe a Medicare review should be clear, thoughtful, and centered on your questions. Learn more about Medicare coverage, Medicare Advantage plans, and Medicare Part D prescription drug coverage, then book a Medicare consultation
for guidance tailored to your situation.
FAQ
Do I have to change my Medicare plan before December 7?
No. You are not required to make a change simply because Annual Enrollment is open. However, reviewing your plan is important because plan costs, provider networks, drug formularies, and rules can change from year to year.
What happens if I do nothing during Medicare Annual Enrollment?
If you do not make a change, your current plan may generally continue into the next year, subject to the plan’s availability and updates. Review your Annual Notice of Change so you understand what may be different for 2027.
Can I change my Medicare Advantage plan during the annual enrollment period?
During the October 15 through December 7 enrollment period, you may be able to join, switch, or drop a Medicare Advantage plan. The appropriate choice depends on your current coverage and individual needs.
Why should I review Medicare Part D every year?
Drug lists, pharmacy networks, coverage rules, premiums, and out-of-pocket costs can change. Reviewing Medicare Part D with an updated medication list helps you understand how your prescription coverage may work in the next year.
When would new Medicare coverage begin?
For changes made during the October 15 through December 7 enrollment period, coverage generally begins January 1 of the following year, as long as the plan receives your enrollment request by December 7.