5 Things That Can Change About Your Medicare Coverage Each Year

Medicare coverage isn't static. Each year, several key aspects of your coverage can change, and understanding these changes helps you make informed decisions during Annual Enrollment Period.

Plan Benefits and Coverage. Medicare Advantage and Part D plans can modify their coverage annually. Your plan might add or remove covered medications, change copayments for doctor visits, or adjust which pharmacies are in-network. Review your Annual Notice of Change letter carefully each fall.

Costs and Premiums. While Medicare Part B premiums are set nationally (with income-based adjustments), Medicare Advantage and Part D plan premiums vary by plan and can change yearly. Deductibles, copayments, and out-of-pocket maximums may also adjust.

Provider Networks. Medicare Advantage plans can modify their provider networks each year. A doctor or hospital that was in-network this year might not be next year. If you have preferred providers, verify they remain in your plan's network during Annual Enrollment.

Prescription Drug Formularies. Part D and Medicare Advantage plans with drug coverage update their formularies annually. A medication covered this year might move to a different tier with higher cost-sharing, require prior authorization, or be removed from coverage entirely.

Your Health Needs. Your own health status changes over time. New diagnoses, different medications, or changing healthcare needs might mean a plan that worked well last year no longer fits your situation. Annual review ensures your coverage aligns with your current health requirements.