Medicare Open Enrollment: Don't Let Your Medicare Plan Run on Autopilot
Most people only think carefully about Medicare once, the year they turn 65, and then never again.
That's a mistake.
Plans change every year: premiums move, provider networks shift, and drug formularies get revised, often without much notice. Between October 15 and December 7, Medicare's Annual Enrollment Period is your one built-in chance each year to make sure your plan still fits.
Why This Deserves a Second Look Every Year
It's easy to assume last year's plan is still the right one. That assumption can carry a real cost: without comparing this year's Part D and Medicare Advantage options against what you're currently paying, it's easy to miss a better-priced or better-fitting plan without ever realizing it.
What You Can Actually Change During This Window
Join or switch to a different Medicare Advantage plan.
Update your Part D prescription drug plan.
If you're on a Medicare Supplement plan today, your core benefits generally stay the same from year to year, but your premium can still change, and Medigap doesn't cover prescription drugs, so if you also have a separate Part D plan, that part still needs its own annual review.
A Closer Look at Medicare Supplement (Medigap) Plans
Medicare Supplement, often called Medigap, works differently than Medicare Advantage or Part D, and it's worth understanding on its own terms:
Medigap fills the cost-sharing gaps in Original Medicare (deductibles, coinsurance, copays) and works with any provider nationwide that accepts Medicare. There's no network to check each year.
Plans are standardized by letter (A, G, N, and others), so a given plan letter covers the same core benefits regardless of which insurer sells it. Differences between carriers mainly come down to premium and customer service, not coverage.
Since there's no network or formulary attached, Medigap doesn't require the same kind of annual network/formulary check that Medicare Advantage or Part D does. That said, it's still worth confirming your premium for the coming year, since rates can adjust annually even when your benefits don't change.
The trade-off is timing: in most states, enrolling in or switching Medigap plans outside your initial enrollment window can involve medical underwriting, meaning you could be asked health questions or, in some cases, be denied coverage. This is different from Medicare Advantage and Part D, which are guaranteed-issue during Open Enrollment.
A switch between Medicare Supplement and Medicare Advantage, in either direction, is a more involved decision than a typical annual review and is worth discussing with a licensed professional rather than deciding on your own.
A Few Things Worth Checking Before You Decide
Are your doctors, specialists, and preferred hospital still in-network?
Has your pharmacy's cost tier or copay structure changed?
Are your current medications still on the formulary, and at what price?
Has your health changed in a way that makes a different plan type a better fit?
How to Approach the Decision
Comparing Medicare plans on your own can mean sorting through dozens of options in a given zip code. A healthcare planning specialist can help walk through your current plan, medications, and preferred providers against this year's options, and many offer educational webinars on Medicare basics throughout the season if you'd like to start with some background before making any changes.
This is exactly the kind of decision that benefits from being made alongside your broader financial picture, not in isolation. As part of our comprehensive approach to financial planning, we partner with a healthcare planning specialist to give our clients access to this kind of support directly, so Medicare decisions can be considered alongside retirement income, tax planning, and the rest of your financial life, rather than as a separate, disconnected choice made once a year in a vacuum.
The Bottom Line
You don't need to overhaul your coverage every year, but you should check. It's worth starting the process early, well before the December 7 deadline, to leave enough time to review your options and ask questions. Thinking about Medicare as one more piece of a well-coordinated financial plan, rather than a standalone annual task, is part of how we think about planning holistically. Reach out and let’s start the conversation.
DISCLOSURES:
Investment advisory services offered through Consilio Wealth Advisors, a registered investment adviser. The views expressed represent the opinion of Consilio Wealth Advisors. Information does not constitute investment, tax, or legal advice.
Consilio Wealth Advisors does not accept any liability for the use of the information discussed. Consult with a qualified financial, legal, or tax professional prior to taking any action. Before investing, consider investment objectives, risks, fees, and expenses. Investments in securities involve the risk of loss, including loss of principal. Past performance is no guarantee of future returns. The views and opinions reflected in the content are subject to change at any time without notice. The content speaks only as of the date indicated. Some information was obtained from external sources. The information is believed to be accurate, but there is no guarantee that it is.
Consilio Wealth Advisors pays a fee to the third-party healthcare planning specialist referenced in this article in order to make their platform and services available to our clients. Consilio Wealth Advisors does not receive compensation from this specialist or any insurance carrier in connection with this relationship. This arrangement should be considered when evaluating any recommendation to use these services. Clients are not obligated to use any referred third party and are free to choose their own healthcare planning resources.
