YOUR YEARLY MEDICARE CHECKUP
Do I Need to Review My Medicare Plan Every Year?
A yearly review does not mean you need to change plans. It means checking whether your current Medicare Advantage or Part D coverage still fits your doctors, prescriptions, costs and priorities for the coming year.
Yes, Medicare Advantage and Part D coverage should be reviewed every year. Plans can change their costs, formularies, pharmacy arrangements, provider networks, benefits and coverage rules. Your own healthcare needs can change too.
A review may confirm that staying in your current plan is the best fit. It should never begin with the assumption that you must switch.
For Springfield dates and local preparation guidance, use the Medicare AEP 2026 guide.
TWO THINGS CAN CHANGE
Your Plan Can Change—and Your Life Can Change
Your plan changes
Premiums, deductibles, copayments, the medical maximum out-of-pocket limit, prescription tiers, pharmacy pricing, benefits and plan rules may be different on January 1.
Your needs change
You may have new prescriptions, specialists, planned procedures, travel needs, financial priorities or a different preferred pharmacy.
The fit can change
A plan that worked well last year can become less suitable—or remain an excellent choice. The review is how you find out.
Your plan’s Annual Notice of Change is the starting point for reviewing plan changes. It does not know that your cardiologist changed practices, that you started a new medication or that you plan to spend part of the year outside Missouri.
THE FIVE-PART REVIEW
What Should You Recheck Each Fall?
- Doctors and hospitals: verify each important physician, practice location, hospital and outpatient facility for the specific plan and upcoming plan year.
- Prescriptions: check the exact drug, dosage, quantity, tier, deductible, prior authorization, step therapy and quantity-limit rules.
- Pharmacies: compare preferred, standard, mail-order and nearby pharmacy pricing rather than assuming every network pharmacy costs the same.
- Medical costs: review hospital, specialist, outpatient, therapy, imaging, ambulance and durable-medical-equipment cost sharing.
- How you use coverage: consider travel, care outside your immediate area, upcoming treatment and the benefits you realistically use.
- Eligibility and assistance: report changes involving Medicaid, Extra Help, employer or retiree coverage, residence and other insurance.
If a doctor or hospital relationship is your primary concern, read what to do when a Medicare plan loses a doctor or hospital. If a prescription changed, use the guide to a medication that is no longer covered.
STAY OR LOOK CLOSER?
Signs Your Current Plan May Still Fit—and Signs to Investigate
| What you find | What it may mean | Next step |
|---|---|---|
| Doctors, prescriptions, pharmacies and costs still fit | Your current plan may remain a reasonable choice | Confirm the upcoming year’s official plan details before allowing it to renew |
| A key medication moved tiers or gained a restriction | Your total prescription cost or access may change | Compare the exact medication across available coverage and discuss clinical alternatives with the prescriber |
| A doctor or facility is missing from the upcoming network | Routine care access or cost could change | Verify with both the plan and provider, then compare alternatives |
| The premium remains low but hospital or specialist costs rose | The advertised premium may not describe your likely total spending | Compare the whole cost structure, including the medical out-of-pocket limit |
| Your needs changed even though the plan did not | Last year’s comparison may no longer reflect your situation | Run a fresh review using your current information |
TIMING
When Should You Complete the Review?
- When the ANOC arrives: mark every cost, coverage or rule change that could affect you.
- Before plan comparisons begin: update your doctors, prescriptions, pharmacies and priorities.
- During Medicare Open Enrollment: compare your current plan with available alternatives using official upcoming-year information.
- Before submitting anything: verify the effective date, provider participation, prescriptions and how the new election affects existing coverage.
For 2026: Medicare Open Enrollment runs October 15 through December 7, and elections generally take effect January 1, 2027. Specific 2027 Medicare Advantage and Part D plan information may be discussed beginning with the permitted marketing period.
NO PRESSURE TO SWITCH
A Good Review Can End With “Keep What You Have”
There is no prize for changing plans. Switching without a meaningful reason can introduce a different provider network, unfamiliar authorization rules, new pharmacy pricing or coverage surprises.
The decision should be based on your complete situation—not one extra benefit, one television advertisement or one low premium. The best Medicare Advantage fit depends on the individual using it.
The review standard
Understand what your current coverage will do next year, compare it with realistic alternatives and change only when the evidence supports changing.
COMMON QUESTIONS
Annual Medicare Plan Review FAQ
Do I have to change Medicare plans every year?
No. A yearly review is recommended, but changing coverage is not required merely because Open Enrollment is occurring.
Will my Medicare Advantage or Part D plan renew automatically?
Many plans renew when the plan remains available and you remain eligible, but renewal does not mean every cost, benefit, formulary or rule stays the same.
Is the ANOC enough to compare my plan?
It is an essential starting point. You should also use current provider, prescription, pharmacy and healthcare information and verify the official upcoming-year plan details.
Should I review a plan if I did not use much healthcare this year?
Yes. Low utilization does not guarantee that next year’s providers, prescriptions, costs or needs will be identical.
Can Thompson Medicare Brokerage review every plan?
Benjamin can compare the plans he represents and explain relevant coverage considerations. Thompson Medicare Brokerage does not offer every plan available in every area; Medicare.gov, 1-800-MEDICARE and SHIP can provide information about all available options.
ANNUAL PLAN REVIEW SERIES
Continue the Medicare Annual Review Series
These six guides separate the annual review into plan changes, plan endings, prescriptions, Medigap eligibility, total costs and review preparation. For local dates and planning, see Medicare AEP 2026 in Springfield, Missouri.
OFFICIAL INFORMATION
Official yearly review resources
REVIEW THE COMPLETE PICTURE
Check Whether Your Coverage Still Fits
Thompson Medicare Brokerage helps Missouri and Illinois beneficiaries review the Medicare Advantage, Medicare Supplement and Part D considerations that matter to their actual healthcare needs.
Thompson Medicare Brokerage is not connected with or endorsed by the U.S. government or the federal Medicare program. This article provides general educational information. Enrollment rights, coverage, costs, provider participation, formularies and plan availability depend on individual facts, location and the applicable plan year. Thompson Medicare Brokerage does not offer every plan available in every area. Contact Medicare.gov, 1-800-MEDICARE or your State Health Insurance Assistance Program for information about all available options.