Medicare Open Enrollment: Why Most People Should Look Every Year
Every October 15, Medicare's Annual Enrollment Period opens. Most people ignore it. That can quietly cost them thousands.
Every year, between October 15 and December 7, Medicare’s Annual Enrollment Period opens. It’s the window when most Medicare beneficiaries can switch their Advantage plan, change Part D drug coverage, or shift between Original Medicare and Advantage.
Most people don’t use it. They get the same plan re-enrollment letter every year, glance at it, and move on. That’s how a Medicare plan that made sense in 2022 becomes the wrong plan in 2026 — quietly, gradually, without anyone noticing.
What can change in a Medicare plan from year to year
Medicare plans aren’t static. Every year, the carriers update them — and the updates aren’t always announced clearly.
Things that commonly change:
- Monthly premiums (sometimes up, sometimes down)
- Annual deductibles
- Drug formularies — which medications are covered and at what tier
- Pharmacy networks — which pharmacies count as in-network
- Provider networks for Advantage plans — your doctor might be in network this year and out next year
- Supplemental benefits like dental, vision, hearing, transportation, OTC allowances
- Maximum out-of-pocket limits
Any one of these can meaningfully change what your plan actually costs you and what it actually covers. People assume that if they were happy with their plan last year, the same plan will work this year. That’s often not true.
The places people get caught
The most common ways people get burned by ignoring AEP:
Prescription drug surprises. Your insulin, your blood pressure medication, your statin — the formulary changes every year. A drug that was tier 2 last year might be tier 3 this year, doubling your copay. Or it might be removed from the formulary entirely, meaning you pay full price until you switch plans.
Network changes. Advantage plans use provider networks. Your primary care doctor might not be in network next year. Your specialist might. The hospital across town that you’ve been using might not. If you don’t check, you don’t know — until you go to an appointment and find out.
Premium creep. Plans that were $20 a month can become $45 a month over a few years. That’s not a 5% inflation increase — that’s the carrier repricing because they’re allowed to. Comparing your plan against the current market every year tells you whether you’re still in a good place.
Better plans for your situation. Sometimes a plan that didn’t exist when you originally enrolled becomes available — or a plan that wasn’t competitive in your area becomes competitive. You don’t know unless you look.
What an annual review actually involves
The annual Medicare review isn’t complicated. It takes about 30 minutes if your situation hasn’t changed much.
What we look at:
- The drugs you’re currently taking — and how those drugs are covered by your current plan and by alternatives
- Your doctors — and which plans they participate in
- Your usage patterns over the past year — how often you went to specialists, whether you traveled and needed out-of-network care, whether your needs changed
- Your premium versus alternative premiums for similar coverage
- Any new plans available in Nashville this year that didn’t exist last year
If everything still looks right, we leave you in your current plan. If something better has come along, we walk you through the comparison. The decision is always yours.
The October Life Review
For our clients, this is built into a broader annual conversation we call the Life Review. Every October — before AEP opens — we sit down for a structured review of your full coverage picture. Not just Medicare, but home, auto, life, long-term care, retirement income, business if applicable.
Medicare is the most time-sensitive piece because of the enrollment window, but it’s not the only thing that changes year to year. Home values change. Health changes. Family situations change. Coverage that fit a year ago might not fit now.
The Life Review is how we make sure your coverage actually evolves with your life — instead of staying frozen the year you originally bought it.
If you’re not currently working with us
If you’re on Medicare and you’d like a second opinion on your current plan — or you’ve never had anyone properly walk you through the alternatives — that’s a Discovery Meeting. No pressure to switch. We compare across all the plans available in Nashville and tell you honestly whether your current plan is still the right one.
Call (615) 326-9899 or schedule a Discovery Meeting. October is the right time to start this conversation.