Our Services
Annual Coverage Review
Your Medicare plan can change its costs, drug formulary, and provider network every year — and so can your health. Each autumn during the Annual Enrollment Period (October 15 – December 7) we review your plan against the new options to make sure it's still the right fit. If you do nothing, you're automatically renewed into next year's version.
Why it matters more than people think
A plan that was ideal last year can move your medication to a higher tier, drop your cardiologist from the network, or raise its out-of-pocket maximum — with no change in your health at all. Carriers have also withdrawn plans from New Mexico counties entirely.
A 15-minute review each autumn is the difference between choosing your coverage and inheriting it.
The three things we check
- Your doctors — still in network for the new plan year?
- Your drugs — still on the formulary, at the same tier, without new restrictions?
- The out-of-pocket maximum — did it move?
Everything else is secondary to those three.
Read your Annual Notice of Change
Your plan must send an Annual Notice of Change each September setting out what's different for January. It's the most important piece of Medicare post you'll get all year, and the one most often binned unopened. Bring it to your review.
The windows for changing
- October 15 – December 7 — anyone can change Advantage or Part D plans, effective January 1.
- January 1 – March 31 — Advantage members get one switch, or can return to Original Medicare.
- Special Enrollment Periods — moving, losing coverage, gaining Medicaid or Extra Help.
Detail on Medicare.gov. Note that AEP does not guarantee you a Medigap policy — see the Medigap rules.
What it costs
Nothing, every year, for as long as you're our client. Carriers pay our fee, not you.
Booking your review
We reach out each autumn, but you're welcome to book earlier — October fills up.
Not sure which of these fits you? A free 15-minute call with a licensed local advisor sorts it out — no pressure, and no cost to you. We do not offer every plan available in your area. For a complete list of every plan in your county, use Medicare Plan Compare or call 1-800-MEDICARE.
What to have ready each autumn
The review takes about fifteen minutes if you have these to hand.
- Your Annual Notice of Change, which arrives each September.
- Your current plan card.
- Any changes to your prescriptions in the past year.
- Any new doctors or specialists you've started seeing.
- Anything that frustrated you about the plan this year.
That last one matters more than people expect. Prior-authorisation delays, a pharmacy that stopped being preferred, or a specialist who left the network are all fixable at Annual Enrollment — but only if we know about them.
If nothing needs to change
Plenty of reviews end with a recommendation to stay exactly where you are, and that's a real outcome rather than a wasted appointment. If your doctors are still in network, your drugs are still on the same tier, and the out-of-pocket maximum hasn't moved, then your plan is still the right plan and switching for its own sake would only risk disruption.
What you get from the review either way is documentation: a record of what was checked and when, so if something goes wrong in March you know it wasn't a change you missed in October.
Questions, answered
Do I need to review my plan every year?
Yes — plans and your needs both change. We review yours every autumn during Annual Enrollment so you're never stuck with a worse plan by default.
What if my plan is being discontinued?
You get a Special Enrollment Period to choose another plan, and in some cases a guaranteed-issue right to buy Medigap without underwriting. Contact us as soon as you get the notice — the options are better earlier.
Can I switch plans outside Annual Enrollment?
Only with a Special Enrollment Period, or during January 1 – March 31 if you're already in a Medicare Advantage plan.
Sources
- Medicare.gov — Joining a plan
- Medicare.gov — When to buy a Medigap policy
- Medicare Plan Compare
- Medicare.gov — Part D costs
- Medicare.gov — Medicare Advantage health plans
Figures are current-plan-year and come from the official sources above. Plan-specific costs vary by county and carrier — confirm yours on Medicare Plan Compare or with a licensed agent.
Content reviewed by Brian Penner, Independent Medicare advisor — no pressure.