If your Medicare plan were a smartphone, would you keep the same model forever and hope the updates just…work? Exactly. Medicare changes annually, and so do your health needs and costs. A quick yearly review could save you money, prevent surprises at the pharmacy counter, and keep your care team in-network. Consider this your friendly nudge to run an annual benefits audit.

The 60-Second Business Case

  • Plans change: Premiums, copays, drug tiers, and provider networks are refiled every year. Note: I’m referring to Medicare Advantage and prescription drug plans.
  • You change: New prescriptions, procedures, or doctors can turn a “good enough” plan into a budget buster.
  • The window is short: Annual Enrollment Period (AEP) runs October 15–December 7.

What Actually Changes Each Year

  • Premiums, Deductibles and Copays: Can reset or rise.
  • Drug Formularies: Your medication may change tiers or require prior authorization.
  • Pharmacy Networks: Your favorite pharmacy might lose preferred status, leading to higher copays.
  • Doctor & Hospital Networks: Providers can leave or join networks; out-of-network = out-of-pocket.
  • Supplemental Health and Wellness Benefits: Dental, vision, hearing, OTC allowances, transportation, gym memberships can change.

Who Should Definitely Review

  • Anyone with new prescriptions or dosage changes.
  • If you saw new specialists or had a hospital stay this year.
  • If your plan raised your costs or cut benefits in the Annual Notice of Change (ANOC).
  • If you moved or split time between two locations.
  • If you were surprised at the pharmacy more than once.

A Fast, Friction-Light Review Workflow

  1. Pull your ANOC & EOC: Flag changes in premiums, copays, drug tiers, and network notes.
  2. List your “utilization profile”: Current meds (name/dose), preferred pharmacies, doctors, and expected procedures.
  3. Run the numbers: Compare plans with your exact meds and providers. Look at annual costs, not just premiums.
  4. Check the fine print: Prior authorizations, step therapy, quantity limits, and referral rules.
  5. Decide before December 7: Lock it in; set a calendar reminder for next AEP.

Bottom Line

Medicare isn’t “set it and forget it.” It’s “review and improve.” Plans change. Your health evolves. Markets shift. A quick annual check ensures your coverage stays aligned with your needs.

We don’t offer every plan available in your area. Any information provided is limited to those plans we do offer. Please contact Medicare.gov, 1-800-MEDICARE, or your State Health Insurance Program to get information on all of your options.