AEP – The Medicare Annual Enrollment Period: Is It Time to Change Your Plan?

It’s that time of year again.
Full mail and email inboxes. Obnoxious phone calls and texts. Mindless advice from well-meaning friends and relatives. Never-ending TV and radio ads. But, should you consider changing your Plan?
It can feel like the Medicare Annual Enrollment Period (AEP) which runs from October 15 to December 7 is just one big stress ball of noise and confusion. Every year, it’s the same story: your mailbox fills with offers for Medicare Advantage plans, Medigap promotions, and updates from your current provider. Meanwhile, your phone rings with unsolicited calls, all promising the perfect plan for you.
So, what should you do? Should you really change your plan? Or are you just being swept up in the annual chaos?
It’s easy to get lost in the shuffle of offers, commercials, and unsolicited advice. But before you make any decisions, it’s important to stop and think:
What’s actually best for your needs?
At its core, AEP is about evaluating your Medicare plan options to make sure you’re getting the best coverage at the best price. But with all the noise, it’s easy to feel overwhelmed.
Here’s the thing: You don’t have to make a hasty decision.
Instead, ask yourself these key questions before diving into any changes:

Why This Time of Year Feels Like a Medicare Frenzy

1. Are You Happy with Your Current Coverage?

Before you start shopping around for a new plan, take a moment to evaluate your current situation.
  • Are your doctors still in-network?
  • Do you have the prescription coverage you need?
  • Have your healthcare needs changed?
    If your health has been stable and your current plan is meeting your needs, there might be no reason to make a change. But if you’re finding that you’re paying more than necessary or your plan no longer fits your situation, it might be time to explore other options.

2. Do You Understand the Plan Changes for 2025?

Every year, Medicare plans change—whether it’s premium increases, changes in drug formularies, or updated coverage networks. You might get an Annual Notice of Change (ANOC) from your current provider, outlining what’s different for the coming year.
  • Are you aware of any changes to your plan’s benefits or costs?
    If you haven’t reviewed your ANOC yet, now is the time. Understanding these changes can help you make an informed decision about whether your current plan is still the best choice or if you need to consider something new.

3. Are You Considering a Switch to Medicare Advantage?

Medicare Advantage (Part C) plans have gained popularity in recent years because they combine the benefits of Original Medicare with added perks like vision, dental, and wellness programs all for a potentially lower monthly premium. But not all Advantage plans are created equal.
  • Is your current Medicare Advantage plan still meeting your needs?
    Some people find they’re paying too much for limited coverage or network restrictions. While a Medicare Supplement plan may offer broader coverage and fewer network limitations, the low-cost appeal of Medicare Advantage is tempting for those on a fixed income.

4. Can You Afford the Changes?

As with any insurance, it’s crucial to consider the costs involved. Medicare Advantage plans may have low or $0 premiums, but they often come with copayments and out-of-pocket limits that could add up over the course of the year.
  • What’s your budget for health insurance? Take a moment to assess what you’re paying now for premiums, deductibles, and copays. You don’t want to end up paying more just to switch to a new plan that might not even meet your needs.

5. Are You Getting the Right Advice?

If you’ve been listening to friends, relatives, or even TV commercials, you might be getting advice that’s not tailored to your situation.
  • Your Trusted Advisor can guide you through with unbiased advice. At the end of the day, if you’re happy with your plan it’s probably your best option.

6. Is There a Better Option You Haven’t Considered?

Maybe it’s time to consider alternatives. If you haven’t looked into High Deductible Plan G, Medicare Advantage with prescription coverage, or Medigap in a while, it’s worth doing a comparison. Each year, Medicare Advantage plans introduce new benefits, and Medigap plans might offer better coverage at lower costs if you’ve been healthy.
  • Are you open to looking beyond what you know?
    A little research can help you discover options that may save you money or offer better coverage than what you’re currently paying for.

Final Thoughts: Take Your Time

As you approach the AEP and evaluate your Medicare options, remember: this isn’t about rushing into a decision or getting caught up in the latest ad.
It’s about taking the time to review your needs, understand your options, and ask the right questions. You don’t have to make a change if your current plan is still the right fit. But if it’s time to reassess, you have plenty of resources at your disposal to help guide you.

Choosing the Right Medicare Coverage

Selecting the best Medicare coverage depends on factors like your healthcare needs, budget, and preferred providers. You can choose between:
  • Original Medicare (Parts A & B): Allows you to see any doctor or
    hospital that accepts Medicare but does not include prescription drug
    coverage (Part D) or additional benefits.
  • Medicare Advantage (Part C): Offers bundled coverage with
    potential extra benefits but may require using a network of providers.
  • Medigap (Medicare Supplement Insurance): Helps cover
    out-of-pocket costs not covered by Original Medicare, such as
    copayments and deductibles.

Key Medicare Enrollment Periods

It is crucial to enroll in Medicare at the right time to avoid penalties and ensure continuous coverage:
  • Initial Enrollment Period (IEP): A seven-month window starting
    three months before your 65th birthday month.
  • General Enrollment Period (GEP): From January 1 to March 31
    each year for those who missed their IEP.
  • Annual Election Period (AEP): From October 15 to December 7,
    allowing you to switch or enroll in Medicare Advantage and Part D
    plans.
  • Open Enrollment Period(OEP): From January 1 to March 31 for
    those who missed AEP and want to make certain changes.
  • Special Enrollment Period(SEP): Can be used anytime during the
    calendar year for those that meet certain criteria such as moving to a
    new service area.

Finding Help with Medicare

Understanding Medicare can be complex, but you don’t have to do it alone. Licensed Insurance Brokers, Medicare.gov, and state health assistance programs can provide guidance tailored to your specific needs.
By taking the time to explore your Medicare options, you can make informed decisions that ensure you receive the healthcare coverage that best suits your lifestyle and budget.
Do I have to sign up for Medicare?
It depends upon your current coverage. If you are employed and your employer has over 20 employees then you can delay signing up for Medicare and avoid penalties.
No, You will have to enroll in a stand alone Part D plan or a Medicare Advantage Plan(Part C) to get coverage.
There are no networks with Medicare and most doctors and hospitals accept it. However, Medicare does not cover 100% of services so a Medicare Supplement or Medicare Advantage plans is advisable.

Mike Miligi- Owner

For over 10 years, Mike has been assisting Seniors and other Medicare-eligible individuals in understanding the ins and outs of Medicare and Medicare Health Insurance options, including Medicare Advantage Plans(Part C), Medicare Supplement Plans(Medigap), Prescription Drug Plans(PartD), and Dental and Vision programs.
Mike is Licensed in seven States and Certified with 11 Insurance Carriers. He has helped thousands of individuals decide on the best course of action for their particular Health Insurance needs. Because Mike is an Independent Medicare Health Insurance Broker, he works for the client, not the Insurance Carriers, and is able to provide his clients with accurate and unbiased Health Insurance options.
Mike recertifies with CMS(The Centers for Medicare and Medicaid Services) annually, regularly completes Continuing Education Courses required by individual State Insurance Departments, and keeps abreast of industry trends and standards to offer his clients the most up-to-date information.
Scroll to Top