Do You Really Have to Change Your Medicare Plan?

Understanding when it makes sense to stay put — and when it doesn’t
Every fall, when the Medicare Annual Enrollment Period (AEP) opens, the pressure to change plans is everywhere. Commercials, postcards, and phone calls all push the idea that you must switch to something new.
Here’s the truth: you don’t have to change your Medicare plan every year. But you should take the opportunity to review your coverage. Sometimes staying put is the best choice. Other times, a change can save you money or give you better protection.
There’s peace of mind in knowing your plan is still a good fit. You might decide to stay if:
  • Your doctors and hospitals are still in-network.
  • Your prescriptions are still covered affordably.
  • Your premiums and copays haven’t increased significantly.
  • You’re comfortable with your plan’s benefits (dental, vision, hearing, etc.).
Bottom line: If your plan still meets your needs and your budget, you’re not required to make a change.

When Staying Put Makes Sense

That said, Medicare plans can change every year. Consider switching if:
  • Your Annual Notice of Change (ANOC) shows higher premiums, deductibles, or copays.
  • Your medications are dropped or moved to a higher tier.
  • Your doctor leaves the network (for Medicare Advantage).
  • You’ve had new health needs — more specialist visits, new prescriptions, or a recent hospitalization.
  • Your budget has changed and you need lower monthly costs.
Bottom line: A plan that fit last year may no longer be the best choice for you in 2026.

When It Might Be Time to Switch

The Risk of Doing Nothing

If you don’t review your plan at all, you might not notice changes until you’re sitting at the pharmacy counter or your doctor’s office. By then, it’s too late to make a switch until the next
enrollment period.

How to Make the Right Decision

Here’s a simple process:
  • Read your ANOC carefully for cost and coverage changes.
  • List your doctors and prescriptions.
  • Compare options using Medicare.gov, your plan’s materials, or (better yet) a broker who can look across multiple companies.

Key Takeaway

The Medicare Annual Enrollment Period isn’t about forcing you to switch. It’s about giving you the chance to check whether your plan still fits.
If it does, staying put is perfectly fine. If it doesn’t, you have from October 15 to December 7 to make a change. Either way, the best step you can take is to schedule time with your broker — so you can move into 2026 confident you’ve made the right call.

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.
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