Already on Medicare?
How to Review Your Coverage
Many individuals continue to review their Medicare coverage after their initial enrollment.
Changes in health needs, provider networks, and plan structures can affect how well your current plan meets your needs. Understanding how Medicare coverage works over time can help individuals make informed decisions when reviewing their benefits. This guide explains what individuals already enrolled in Medicare should know when reviewing their coverage.
Situations When Medicare Coverage Should Be Reviewed
Changes in Prescription Medications
- If prescription medications change, it may be helpful to review how those medications are covered under a current plan’s formulary. Drug formularies can change from year to year, which may affect costs or coverage.
Changes in Healthcare
Providers
- Some Medicare plans operate with provider networks. If a doctor or specialist changes their participation in a network, individuals may wish to review their coverage options.
Changes in Plan
Benefits
- Medicare Advantage and Part D plans can change their premiums, deductibles, and networks annually. Reviewing plan changes helps you understand how your benefits are affected.
Common Questions From People Already on Medicare
Can I change my Medicare plan?
Some Medicare plans may be changed during specific enrollment periods.
- Examples include:
- Annual Enrollment Period
- Medicare Advantage Open Enrollment Period
Each enrollment period has specific rules and timelines.
Do Medicare plans change every year?
Certain plan elements may change each year, including:
- Premiums
- Provider Networks
- Prescription Drug Coverage
Annual plan notices provide information about these changes.
How do I know if my current plan is still appropriate?
Individuals often review their Medicare coverage when their healthcare needs or medications change.
Understanding plan structures and benefits can help individuals better evaluate their options.
Medicare Coverage Structures
Individuals already enrolled in Medicare generally have coverage structured in one of the following ways:
Original Medicare
- Original Medicare includes:
- Medicare Part A (hospital coverage)
- Medicare Part B (medical coverage)
- Many individuals also add:
- Medigap policy
- Part D prescription drug plan
Medicare Advantage Plans
Medicare Advantage plans are offered by private insurance companies approved by Medicare.
- These plans typically combine:
- Part A
- Part B
- Often Part D prescription drug coverage
Plan structures can vary depending on the insurance carrier and service area.
When Medicare Coverage Is Typically Reviewed
Annual Enrollment Period
October 15 — December 7
The window to adjust Medicare Advantage or Part D coverage for the following year.
Medicare Advantage Open Enrollment
January 1 — March 31
A time for those in an Advantage plan to make limited coverage changes.
Medicare Educational Videos
Short educational videos explaining Medicare rules and coverage structures are available in the Medicare video library.
These videos explain topics such as:
- How Medicare works
- How enrollment timelines operate
- How coverage options differ
- Common Medicare questions
Frequently Asked Questions
Can I change my Medicare plan anytime?
Plan changes are typically allowed only during specific enrollment periods unless special circumstances apply.
Do Medicare plans automatically renew?
Many plans renew annually, but plan benefits and costs may change.
Where can I get help understanding Medicare?
Many individuals review their coverage annually to understand plan changes and how those changes may affect benefits.