5 Reasons Seniors Should Review Their Medicare Every Year (And How to Make It Easy)

If you've been on Medicare for a few years, you might think you can just "set it and forget it." After all, once you've found a plan that works, why mess with a good thing? Here's the truth: Medicare isn't like your favorite coffee shop that stays the same year after year. It's more like a moving target, and if you're not paying attention, you could end up paying more or getting less coverage than you need.

Let's dive into why an annual Medicare review isn't just recommended: it's essential for protecting both your health and your wallet.

Reason #1: Medicare Plans Change Every Single Year

Think of Medicare plans like smartphones: there's always a new version coming out with different features, and sometimes your old model gets discontinued entirely.
Every year, Medicare Advantage plans and Part D prescription drug plans can modify their benefits, add or remove covered medications, change their provider networks, and adjust their costs.

What was covered last year might not be covered this year. That specialist you love? They might no longer be in-network. Your heart medication that cost $10 last year? It could jump to $50 this year if it's moved to a different tier on your plan's formulary.
Insurance companies aren't required to notify you of every change: they'll send you an Annual Notice of Change (ANOC) in late September, but let's be honest, those documents can be as confusing as tax forms. That's why you need to actively review what's changing instead of assuming everything stays the same.

Reason #2: Your Health Isn't Static

Remember when you were 65 and thought you'd never need to see a cardiologist? Fast forward a few years, and maybe you're dealing with high blood pressure, diabetes, or joint issues you never saw coming. Your Medicare plan needs to evolve with your health.

If you've developed new conditions, you might need:

• Access to specialists who weren't important to you before
• Different medications that your current plan doesn't cover well
• Medical equipment or services your current plan treats as "extras"
• More predictable costs if you're now seeing doctors regularly

On the flip side, maybe your health has improved, or you're no longer taking expensive medications. You might be paying for coverage you don't need anymore. Either way, your Medicare plan should match your current reality, not where you were five years ago.

Reason #3: Provider Networks Are Like Musical Chairs

Just because Dr. Smith was in your plan's network last year doesn't guarantee he'll be there this year. Insurance companies negotiate new contracts annually with doctors, hospitals, and other healthcare providers. Sometimes these negotiations don't go well, and providers get dropped from networks.

This isn't just about convenience: it's about money. If your favorite doctor leaves your plan's network, you'll either need to:

• Pay significantly more to continue seeing them (often the full cost)
• Find a new doctor within your network
• Switch to a plan that covers your preferred provider

The same goes for hospitals, pharmacies, and specialists. A plan that gave you great access last year might leave you scrambling to find new providers this year.

Reason #4: Costs Can Swing Wildly

Medicare costs aren't set in stone. Premiums, deductibles, copays, and out-of-pocket maximums can change dramatically from year to year. A plan that was budget-friendly last year might become your most expensive option this year.

Here's what can change:

• Monthly premiums: Some plans increase premiums, others might lower them to attract new members
• Deductibles: The amount you pay before coverage kicks in can go up or down
• Copays and coinsurance: Your costs for doctor visits, medications, and procedures can shift
• Out-of-pocket maximums: The most you'll pay in a year can change significantly

Sometimes plans use low premiums as bait to attract new members, then gradually increase costs in subsequent years. Other times, plans might lower their costs to stay competitive. You'll never know unless you compare options annually.

Reason #5: Better Options Keep Appearing

The Medicare market is competitive, which means insurance companies are always trying to one-up each other with better benefits, lower costs, or both. New plans enter the market every year, while existing plans might add appealing benefits to attract members.

You might discover plans that offer:

• Better prescription drug coverage for your specific medications
• Lower overall costs for your typical healthcare usage
• Extra benefits like dental, vision, or hearing aids
• Better customer service ratings
• Wellness programs or gym memberships

If you don't look, you'll never know what you're missing. That perfect plan for your needs might have launched this year, but you'll stick with a mediocre option simply because you didn't shop around.

How to Make Your Annual Review Actually Manageable

Now that you understand why reviewing your Medicare annually is crucial, let's talk about how to do it without pulling your hair out.

Start With Your Medications

Before you dive into comparing plans, make a complete list of all your prescription medications, including dosages. This is your most important tool for comparison shopping. Use Medicare's Plan Finder tool on Medicare.gov to see which plans offer the best coverage for your specific drugs.

Set Aside Dedicated Time

Don't try to squeeze Medicare shopping into commercial breaks during your favorite TV show. Block out a few hours (or spread it over several days) to properly compare your options. Open Enrollment runs from October 15 to December 7: plenty of time if you start early.

Use Professional Help

You don't have to navigate this alone. State Health Insurance Assistance Programs (SHIP) provide free, unbiased counseling to help Medicare beneficiaries understand their options. Local agencies on aging often offer similar services. At VitalShield Insurance Services, we specialize in helping people find Medicare plans that actually fit their needs and budgets.

Create a Simple Comparison Sheet

Don't get lost in the details. Focus on what matters most to you:

• Monthly premium
• Annual deductible
• Your typical copays (doctor visits, specialist visits, prescriptions)
• Whether your doctors are in-network
• Star ratings for customer satisfaction

Check Star Ratings

Medicare rates plans on a 1-5 star scale based on quality and customer satisfaction. While stars aren't everything, they give you insight into how other people feel about their plans. Generally, 4-5 star plans offer better service and member satisfaction.

Don't Forget About Timing

If you decide to switch plans, your new coverage starts January 1st. Make sure any new plan covers your medications and that you understand any waiting periods or prior authorization requirements.

The Bottom Line

Medicare isn't a "set it and forget it" decision. Your health, your finances, and your options change every year. Spending a few hours annually reviewing your Medicare coverage can save you hundreds or even thousands of dollars while ensuring you get the healthcare you need.

Think of it like checking your smoke detector batteries: it's not the most exciting thing to do, but it's essential for protecting what matters most. Your annual Medicare review is your chance to make sure you're getting the best value and coverage for your specific situation.

If you're feeling overwhelmed or want professional guidance through the process, contact us at VitalShield Insurance Services. We're here to help make Medicare make sense, so you can focus on what really matters: staying healthy and enjoying your retirement.