Getting Ready for Medicare’s Annual Enrollment Period: What to Know

Medicare’s Annual Enrollment Period (AEP) is right around the corner. Now’s the time to evaluate your health care needs for the coming year and make sure you’re getting the right Medicare coverage for your health requirements and budget. Your partners at Walsh Duffield are here to help! Read on to learn how to prepare and get no-cost assistance from our dedicated Medicare team.

The Medicare AEP runs from October 15 – December 7 every year. During this period, you can join, drop, or change your existing Medicare plan. If you are a current Medicare Plan beneficiary, you will receive your Annual Notice of Change (ANOC) in September. This mailing (or email) from your insurance carrier will detail any changes in coverage, prescription drug plans, costs, rules, or service area that will take place in January. On October 1, plan information for the upcoming year is released to the public and you can begin your comparisons. With a limited timeframe to review your options, being prepared for AEP is key to finding the plan that is best for you. Let’s begin!

Thoroughly review your Annual Notice of Change (ANOC)

Once you receive your ANOC from your carrier make the time to read it carefully, so you’ll fully understand any plan changes for the next year, including all covered medications, doctors, and specialists. These changes can have a direct impact on your healthcare coverage decisions during AEP.

If you are satisfied with your current Medicare plan, you don’t have to take any action during AEP, but Medicare plans do change annually and new plans are introduced so it is important to review your plan and compare your options to make sure you aren’t overpaying or that you aren’t missing out on benefits like dental, vision, OTC, fitness, and hearing coverage

Outline your healthcare needs for the next year

The plan that worked for you last year, may not address your healthcare and lifestyle needs in the coming year. As you review your ANOC, consider the following factors. It is a great idea to utilize this downloadable checklist to take notes as you go through these questions:

Changes in health

  • Has your health changed?
  • Were you newly diagnosed with a chronic condition?
  • Are you going to need to see specialists in the upcoming year?
  • Will you need surgery, like a knee or hip replacement?
  • Do you want extra coverage for hearing, dental or vision?


  • Does your current plan cover the prescription medications you need?
  • Were you prescribed any new medications or taken off any previous medications?
  • Is your pharmacy considered “preferred” with your current plan?
  • If you are a diabetic, does your plan participate in the CMS Part D Senior Savings Model?

Provider networks

  • Are your preferred healthcare providers and facilities in your network?
  • Is your provider list up to date?
  • Will you need to see any doctors outside of your service area in the upcoming year?


  • Does your plan cover out-of-network services? At what cost?
  • How much will you have to pay in premium and copays/coinsurance?
  • How much will your prescriptions cost, and will you fall into the coverage gap?
  • What is your out-of-pocket maximum?
  • Does your plan participate in the Medicare Buy Back/Give Back program?

Know your options

Now that you’ve evaluated what kind of coverage you will need next year, you can assess your options. There are a lot of options! Here are the changes you can make during the Annual Enrollment Period:

  • Switch to Medicare Advantage from Original Medicare, Part A and Part B
  • Switch from Medicare Advantage to Original Medicare, Part A and Part B
  • Change from one Medicare Advantage plan to another
  • Enroll in a Part D prescription drug plan
  • Switch from one Medicare prescription drug plan to another

Find your plan

Thorough fact finding can help you answer most of the questions above. Because comparing plans can be overwhelming, it can be very helpful to work directly with an unbiased agent in your area who is licensed, educated and certified on the Medicare market and can help you choose the plan that is the right fit for you. The good news is, your partners at Walsh Duffield are here to help and can meet with you one-on-one, at no cost to you, wherever you are most comfortable. . .even virtually!

Click here to Schedule a Medicare Consultation with one of our dedicated Benefits Consultants. We’re here to help you simplify Medicare’s Annual Enrollment Period.

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