Your Medicare Annual Enrollment Checklist: What to Check Before December 7

The envelope you probably set aside in September

Every fall, anyone on a Medicare Advantage or Part D plan gets a thick envelope from their insurance company. Most of it is boilerplate. One part of it is not. The Annual Notice of Change, the ANOC, is the plan telling you in writing exactly what it is changing on January 1. Plans are required to get it to you by September 30, which is fifteen days before the enrollment window opens, and that timing is not an accident. You are supposed to read it, then decide.

If you are on Original Medicare with a Medicare Supplement, you do not get an ANOC. There is no annual plan change to review. Your Part D drug plan still sends one.

What the window actually is

Annual Enrollment runs October 15 through December 7. Whatever you choose during that window starts January 1. If you change nothing, your current plan rolls into next year with whatever changes the ANOC described. Doing nothing is a decision, and for a lot of people it is the right one. It just should not be the default by accident.

Five things worth checking

You do not need to read all forty pages. Check these.

• Your prescriptions, by name. Formularies change every year. A drug that was covered can move to a higher tier, require prior authorization, or come off the list. This is the single most common reason a plan that worked last year does not work next year.
• Your doctors and your hospital. Networks change too. Confirm your primary care physician, any specialist you see regularly, and the hospital you would actually want to go to are all still in network for next year, not just this year.
• The premium and what you pay at the point of care. Not just the monthly premium. The copay to see a specialist, the cost of an inpatient stay, the maximum you could be out of pocket in a bad year.
• The extras you actually use. Dental, vision, hearing, over-the-counter allowances and fitness benefits get advertised hard and trimmed quietly. If you use one, verify it is still there at the same level.
• Whether the plan is still being offered at all. Plans exit counties. If yours is leaving, you will get a separate non-renewal notice, and you get a special window to pick something else. Do not wait for January to find out.

What this window is not

Two things get confused with Annual Enrollment every year.

The first is the Medicare Advantage Open Enrollment Period, January 1 through March 31. That one is narrower. If you are already in a Medicare Advantage plan, you can switch to a different one or go back to Original Medicare. You cannot use it to join a Medicare Advantage plan from Original Medicare.

The second is Medicare Supplement. Switching Medigap plans is not an Annual Enrollment activity in most cases. Outside your one-time open enrollment window or a guaranteed-issue situation, a Medigap carrier in Florida can ask health questions and turn you down. People assume October means open season on everything. It does not, and finding that out in November is a bad way to learn it.

When the right move is to do nothing

If your drugs are still covered at the same tier, your doctors are still in network, and the costs look close to this year, close the envelope. You are done. A plan review that ends in no change is not a wasted review. It is the confirmation that you are in the right place, which is worth something on its own.

Where it gets worth a second set of eyes is when one thing changed and you are not sure how much it matters. A tier change on one maintenance drug can cost more over twelve months than a premium difference that looks much bigger on paper. That is the kind of math that is easy to get backwards.

What a review looks like

Ours takes about half an hour. Bring your plan card, your ANOC if you still have it, and a list of your prescriptions with the dosages. We run your actual drug list against the plans available in your county, check your doctors against each network, and show you the twelve-month cost, not the monthly premium. If your current plan wins, we tell you to stay. There is no fee either way, and we are not going to call you in February about something else.

If you miss it

After December 7, your options narrow to specific situations: moving out of your plan’s service area, losing other coverage, qualifying for Extra Help or Medicaid, your plan leaving your county, and a handful of others. These Special Enrollment Periods are real and they are not rare, but they are not something to plan around. The window that is open to everyone is the one that closes on December 7.