AEP checklist: 10 things to review before December 7

The 10-item checklist

1. 1

   1. Is your plan still offered next year?

   What to check:

   Whether your plan will be around on January 1.

   Where to find it:

   A separate letter from your plan, usually in early fall, if it's ending or leaving your county. No letter like that generally means your plan continues.

   Why it matters:

   If your plan is ending, you'll need to pick new coverage. You also get extra time to do it, so don't ignore that letter.

2. 2

   2. Your monthly premium

   What to check:

   What the plan will cost you each month next year compared with this year.

   Where to find it:

   Your ANOC letter (Annual Notice of Change). The side-by-side table near the front shows this year and next year.

   Why it matters:

   It's the cost you pay every month, whether or not you use the plan. It can go up, down, or stay the same.

3. 3

   3. Your deductible and out-of-pocket maximum

   What to check:

   How much you pay before the plan starts paying, and the most you could pay for covered care in a year.

   Where to find it:

   Your ANOC letter, in the same cost table as the premium.

   Why it matters:

   The out-of-pocket maximum is your worst-case number for the year. A plan with a low premium can still have a high one.

4. 4

   4. Every prescription you take

   What to check:

   That each drug is still on the plan's drug list for next year, and which tier it's in.

   Where to find it:

   The drug section of your ANOC letter, then the plan's full drug list (formulary) for next year on the plan's website. You can also enter your drugs in the plan finder on Medicare.gov.

   Why it matters:

   Drug lists change every year. A drug can move to a higher tier or come off the list, and you'd find out at the pharmacy counter in January.

5. 5

   5. The rules on your drugs

   What to check:

   Whether any of your drugs need prior authorization, step therapy, or have a quantity limit next year.

   Where to find it:

   The plan's drug list (formulary). These rules show up as short codes or notes next to each drug.

   Why it matters:

   A drug can be on the list and still need approval before the plan pays. It's better to know now than when you're out of refills.

6. 6

   6. Your pharmacy

   What to check:

   That your pharmacy is in the plan's network next year, and whether it's a preferred pharmacy.

   Where to find it:

   The plan's pharmacy directory for next year, or call your pharmacy and ask.

   Why it matters:

   The same prescription can cost more at a pharmacy that isn't preferred, and may not be covered at one that's out of network.

7. 7

   7. Your doctors and specialists

   What to check:

   That each doctor you see is in the plan's network for next year. Check them by name.

   Where to find it:

   The plan's provider directory for next year. Then call the doctor's office and ask if they'll be in your specific plan in January.

   Why it matters:

   A doctor can take Medicare and still be outside your plan's network. Networks can change from one year to the next.

8. 8

   8. Your hospital

   What to check:

   That the hospital you'd want to use is in the plan's network next year.

   Where to find it:

   The plan's provider directory, or the hospital's billing and insurance office.

   Why it matters:

   Hospital stays are some of the biggest bills there are. You want to know before you need one.

9. 9

   9. Copays for the care you actually use

   What to check:

   What you'll pay next year for the visits you make most, like primary care, specialists, labs, and therapy.

   Where to find it:

   Your ANOC letter for what's changing. Your Evidence of Coverage has the full list of what you pay for each service.

   Why it matters:

   A few dollars more per visit adds up if you see a specialist every month. Look at the services you use, not the whole list.

10. 10

    10. The extras you count on

    What to check:

    Whether the dental, vision, hearing, or other extra benefits you use are changing.

    Where to find it:

    Your ANOC letter and your Evidence of Coverage.

    Why it matters:

    Extras can change every year. If one of them is a reason you chose the plan, make sure it's still there.

Questions I get about Annual Enrollment

When is the Medicare Annual Enrollment Period?

October 15 through December 7, every year. Changes you make take effect January 1. For 2027 coverage, that means October 15 to December 7, 2026.

What happens if I do nothing during AEP?

In most cases your current plan renews for next year with whatever changes are in your ANOC letter. That's fine if the plan still fits. The risk is finding out in January that a premium, a drug, or a doctor changed, so it's worth a look even if you plan to stay.

What is an ANOC letter and when should I get it?

ANOC stands for Annual Notice of Change. Your Medicare Advantage or drug plan sends it each fall, and you should have it by the end of September. It lists what's changing on January 1. If you can't find yours, call the number on your plan card and ask for another copy.

Can I change my mind after December 7?

Sometimes. If you're in a Medicare Advantage plan on January 1, you can make one change between January 1 and March 31. You can switch to a different Medicare Advantage plan or go back to Original Medicare. Certain life changes, like moving, can also open a Special Enrollment Period.

Does AEP apply to Medicare Supplement plans?

Not in the same way. AEP is for Medicare Advantage and Part D drug plans. A Medicare Supplement, also called Medigap, doesn't have a yearly enrollment window, and switching to a different one may mean answering health questions. If you have a Supplement, your drug plan is the part to review each fall.