One Medicare Review Worth Doing This Fall
Every fall, Medicare opens a window to change your coverage, and it closes faster than most people expect. This year it runs from October 15 through December 7, and anything you change during that stretch takes effect January 1. It's a date worth putting on the fridge.
A quick clarification first, because the terminology trips people up. This window is for people already on Medicare. If you're turning 65 and signing up for the first time, you follow a different timeline tied to your birthday, and this isn't about that. This is the annual chance for current enrollees to look at what they have and decide whether to keep it.
What catches people off guard is that your plan can change even if you do nothing. Insurance companies adjust their costs, drug coverage, and provider networks every year. The plan that fit you well in 2025 might cover fewer of your medications in 2026, drop a doctor you see, or raise a premium you'd gotten used to. Staying with your current plan is a legitimate choice, but it's worth confirming that the coverage still works for you.
When you review, here's what to check:
- Confirm each prescription is still covered, at the same tier and cost
- Check that your doctors and preferred hospitals are still in the plan's network
- Compare this year's premium, deductible, and out-of-pocket maximum against last year's
- Read your plan's Annual Notice of Change for anything that shifted for the coming year
The drug coverage piece is the one people miss most, because the change rarely announces itself. Pull up your current medications and confirm each one rather than assuming it all carried over.
Getting help doesn't cost you anything
You don't have to sort through this alone, and the help is free.
A licensed Medicare broker costs you nothing. They're paid by the insurance carriers, and that payment is already built into the plan, so you pay the exact same premium whether you use a broker or enroll on your own. Federal rules set those commissions and prohibit brokers from charging you for help choosing or enrolling in a Medicare Advantage or Part D plan.
That last point doubles as a safeguard. If someone offers to help you pick or sign up for one of these plans and then asks you to pay them a consultation or service fee for it, treat that as a warning sign. It isn't how legitimate Medicare help works, and a reputable broker will tell you plainly that their assistance is free.
Free also doesn't mean lower quality. Because the commissions are standardized across carriers, a good broker has little financial reason to push one plan over another. Their job is to find the coverage that fits your medications, your doctors, and your budget.
Where we fit in
The enrollment decision is yours, and we aren't licensed to sell Medicare plans or make that call for you. What we can do is help with the financial side: how the premiums and expected healthcare costs fit into your retirement income, and whether the option in front of you makes sense alongside the rest of your plan. If you'd like a second set of eyes before you decide, that's a conversation we're glad to have.
The window is short and the January 1 start date is firm. If a review is in order, October is a much better time to start than the week before the deadline.
For official information or to enroll, visit Medicare.gov or call 1-800-MEDICARE, or work with a licensed Medicare broker.