Every fall, Medicare beneficiaries start receiving a lot of information about their coverage. There are plan notices, letters, advertisements, emails, and reminders about Open Enrollment. It can quickly become a lot to sort through.

And if your current Medicare plan has worked well for you, you might be wondering:

“Do I really need to review it?”

The short answer is: it's worth taking a look. Medicare recommends reviewing your current health and drug coverage each year because plan costs and benefits can change, and your own healthcare needs may change too.

That doesn't mean you need to change plans. It simply means you should know what you're signing up for in the year ahead. With Medicare Open Enrollment beginning October 15 and running through December 7, October is a good time to start your review. Changes made during this period generally take effect January 1.

So, what exactly should you look for?

Let's make it simple.

First: Know What Your Current Medicare Plan Is

Before comparing anything new, make sure you understand what you have now.

Are you enrolled in:

• Original Medicare?

• A Medicare Advantage plan?

• A Medicare prescription drug plan?

• Original Medicare with a Medigap policy and separate Part D coverage?

These aren't interchangeable, and the options available to you can depend on your current coverage. If you have a Medicare Advantage or Medicare drug plan, your plan sends you a Plan Annual Notice of Change (ANOC) each fall. This document explains changes to your plan's coverage, costs, and other details that will take effect in January.

Don't put that envelope in the "I'll read it later" pile. It could contain some of the most important information you'll need for your Medicare review.

1. Did Your Monthly Premium Change?

Start with the number that's easiest to spot: your premium. Your Medicare plan's premium may change from one year to the next. But don't stop there. A plan with a lower premium isn't automatically the better financial fit for you. Other costs—such as deductibles, copayments, coinsurance, and out-of-pocket limits—can matter just as much.

Think about your total potential healthcare costs, not just what comes out of your bank account each month.

2. Did Your Deductible or Copays Change?

This is where your Annual Notice of Change becomes particularly useful.

Look for changes to:

• Deductibles

• Primary care copays

• Specialist copays

• Hospital costs

• Outpatient services

• Urgent care

• Emergency care

• Other frequently used services

A change of only a few dollars here or there might not seem significant. But if you regularly see specialists, take several medications, or receive ongoing treatment, those changes can add up over a year.

3. Are Your Doctors Still in the Network?

This is one of the most important questions to ask if you have Medicare Advantage. Your doctor may have been covered this year—but you shouldn't automatically assume the network will remain exactly the same next year. Check your plan's current provider information and confirm that the doctors and healthcare facilities you use are still included. Pay particular attention to:

• Your primary care doctor

• Specialists

• Preferred hospitals

• Clinics

• Physical therapists

• Other providers you see regularly

Your healthcare team is part of your coverage decision. Don't overlook them while comparing premiums and benefits.

4. Are Your Prescriptions Still Covered?

If you take prescription medications, this deserves a careful review. Prescription drug coverage can change from year to year. Check whether your medications are still covered and review any changes to their costs or coverage requirements. You may want to make a simple list of every prescription you currently take:

Medication → Dosage → How often you take it

Then use that list when reviewing your plan. Also look at whether your medications have changed tiers, whether there are different copays or coinsurance amounts, and whether there are requirements such as prior authorization. This is one reason a plan that worked well for you last year may need another look this year.

5. Look at Your Out-of-Pocket Costs

Here's a question that often gets overlooked:

“How much could I actually spend if I need a lot of healthcare?”

Depending on the type of Medicare coverage you have, your cost structure can be very different. If you're reviewing a Medicare Advantage plan, pay attention to the plan's out-of-pocket maximum for covered services.

Don't just look at the monthly premium.

Imagine two plans:

Plan A
Lower premium, but different cost-sharing when you receive services.

Plan B
Higher premium, but a different structure for copays and other costs.

Neither is automatically right for everyone. The important thing is understanding what each plan could mean for your healthcare spending.

6. Have Your Healthcare Needs Changed?

This may be the most important part of your Medicare plan review. Think back to where you were a year ago. Maybe you barely went to the doctor. Now you're seeing a specialist.

Maybe you started taking three new prescriptions. Maybe you had surgery. Maybe you were diagnosed with a condition that requires regular treatment. Maybe you're traveling more. Maybe nothing changed at all. Your Medicare coverage should be considered in the context of your current needs.

Your health insurance doesn't know what changed in your life. You have to review it.

7. Are Your Plan's Benefits Still Useful to You?

Medicare Advantage plans can offer additional benefits beyond Original Medicare, depending on the specific plan. When reviewing your coverage, don't just look at whether a benefit exists.

Ask yourself:

“Do I actually use this?”

For example, your plan may offer certain benefits that sound attractive, but if they're services you don't use, they shouldn't be the only reason you choose that plan. At the same time, a benefit you didn't care about last year might suddenly become valuable because your circumstances changed.

Look at your actual life—not just the marketing brochure.

8. Check Whether Your Plan Is Changing in a Big Way

Sometimes the changes aren't small. Your plan could make significant changes to its costs, benefits, provider network, or drug coverage. In some cases, a plan may also leave the Medicare program or not renew its contract.

If your plan is changing significantly, you'll want to understand what that means for your coverage for the upcoming year and what options may be available.

Medicare provides specific enrollment opportunities for people whose plans aren't renewed or whose circumstances otherwise qualify them for a Special Enrollment Period. The key is not to ignore the notices you receive.

Do You Need to Change Your Medicare Plan?

Not necessarily. This is important. Reviewing your Medicare plan does not mean you have to switch it.

If your current coverage continues to meet your needs, you may decide to keep it.

Medicare says that if someone with Medicare chooses to keep their current health and drug coverage, they generally don't need to take action during Open Enrollment; the coverage continues, although any new costs or benefit changes take effect for the new year.

The goal isn't to change your plan just for the sake of changing it. The goal is to understand what you're keeping.

When Does Medicare Open Enrollment Start?

For 2026, Medicare Open Enrollment runs:

October 15 – December 7, 2026

During this period, people with Medicare can make certain changes to their Medicare health and drug coverage for the following year.

Depending on your current coverage, you may be able to:

• Join a Medicare Advantage plan

• Switch Medicare Advantage plans

• Leave Medicare Advantage and return to Original Medicare

• Join, drop, or switch a Medicare drug plan

• Make other permitted coverage changes

Changes generally take effect January 1, 2027.

So if you're reading this on October 2, you're actually in a great position to start reviewing your coverage before the enrollment period gets busy.

Your Simple Medicare Plan Review Checklist

Before October 15, gather your information and ask:

💰 Costs

• Did my premium change?

• Did my deductible change?

• Did my copays or coinsurance change?

• What is my potential out-of-pocket cost?

🩺 Doctors

• Are my doctors still in network?

• Is my preferred hospital still covered?

• Are my specialists included?

💊 Prescriptions

• Are all my medications covered?

• Did their costs change?

• Did their coverage tiers change?

• Are there new restrictions?

❤️ Healthcare needs

• Has my health changed?

• Am I seeing more doctors?

• Did I start taking new medications?

• Do I expect different healthcare needs next year?

📋 Plan changes

• Did I receive an Annual Notice of Change?

• Did my plan change its benefits?

• Did anything important change about my coverage?

If you can answer those questions, you'll have a much clearer picture of whether your current Medicare coverage still fits your needs.

Don't Let the Mail Pile Up

October can bring a lot of Medicare information. It's tempting to put the notices aside and think:

"I'll deal with it later."

But later can arrive quickly. Medicare recommends starting your review around October 1, before Open Enrollment begins on October 15. So grab your plan documents, make a list of your medications, check your doctors, and take a little time to understand what's changing.

You don't have to become a Medicare expert overnight. You simply need to understand what you have, what's changing, and what you may need next year.

Frequently Asked Questions

Do I need to review my Medicare plan every year?

It's a good idea to review your coverage each year because plan costs, benefits, provider networks, and prescription coverage can change. Your own healthcare needs can change too.

When is Medicare Open Enrollment for 2026?

Medicare Open Enrollment runs from October 15 through December 7, 2026. Changes made during this period generally take effect January 1, 2027.

Do I have to change my Medicare plan during Open Enrollment?

No. If your current Medicare coverage still meets your needs, you can generally keep it. However, it's important to review any changes to costs and benefits for the upcoming year.

What is the Annual Notice of Change?

The Annual Notice of Change, or ANOC, is a document sent by Medicare Advantage and Medicare drug plans each fall. It explains changes to your plan's coverage and costs that will take effect in January.

What should I compare when reviewing my Medicare plan?

Start with your premiums, deductibles, copays, coinsurance, out-of-pocket costs, doctors and hospitals, prescription medications, and any changes to benefits.

Medicare Doesn't Have to Feel So Complicated

At We Know Life & Health, Dale Earp and Rachel Earp believe that insurance education should help people feel informed—not overwhelmed. Medicare decisions can involve a lot of details, but the process becomes much easier when you break it into smaller questions.

Start with your current plan. Look at what's changing. Think about your healthcare needs. Then compare your options carefully.

And remember: Open Enrollment is an opportunity to review your coverage—not a requirement to change it.

If you have questions about your Medicare options or want help understanding what you're looking at, We Know Life & Health is here to help make Medicare easier to understand.

You may also enjoy these related articles: What Is Medicare Supplement Insurance? A Simple Guide to Medigap

Education first. Relationships always.