How to Review and Update Your Medicare Plan

09.16.2025 | Category: Medicare

Expert Reviewer: Dr. Manoj Pawar, MD, FAAP
Chief Medical Officer, Mutual of Omaha

Summary: Keeping up to date on your Medicare plan is important to make sure it fits your changing healthcare needs. This guide will help you evaluate your current coverage, know when to update it, and make informed choices based on your changing circumstances.

As life circumstances, such as medical needs and financial situations, change over time, it is essential to review your Medicare coverage to ensure it continues to meet your needs.

Medicare has many coverage options designed for different health needs. Some Medicare plans, like Original Medicare (Parts A and B) and Medicare supplement, remain fairly stable from year to year. Plan changes are more likely with Medicare Advantage plans and Part D prescription drug plans; you can add to or change plans during the Medicare Annual Enrollment Period (AEP) each year. Medicare supplement insurance plans can be changed at any time, although the process may require medical underwriting.

To select the right plan that matches your budget and healthcare needs, it’s important to understand these nuances.

When and why to review your Medicare plan

The Medicare Open Enrollment Period (October 15–December 7) occurs each year and is the designated time to review and make changes to your coverage.^1,2 During this period, you can:

Switch from Original Medicare to Medicare Advantage or vice versa.
Join, drop or switch a Part D prescription drug plan.
Switch between Medicare Advantage plans with or without prescription drug coverage.

While Medicare supplement plans can be changed at any time, the annual Medicare AEP is crucial for adjusting Medicare Advantage or Part D coverage for the upcoming year.

Additionally, October 1 is the time to start reviewing any notices from your current plan, such as changes in premiums, benefits or provider networks. Changes made during Open Enrollment take effect on January 1 of the following year.

After December 7, you can still make changes during the Medicare Advantage Open Enrollment Period (January 1–March 31), which allows you to switch from one Medicare Advantage plan to another, return to Original Medicare and join a Part D drug plan, with new coverage beginning the first day of the month after the request is made.¹

During this time, you can ensure your plan continues to meet your needs and avoid any surprise costs in the new year. If you’ve experienced any changes in your health, medications, or providers, this is the time to explore different plans that might better fit your needs.

You may also receive an Annual Notice of Change (ANOC) each year, detailing any alterations to your plan, so you can evaluate whether your current plan still fits your specific circumstances.

Key dates for reviewing and updating your Medicare plan

Knowing when you can make changes to your Medicare plan is just as important as understanding what changes to make. Below are the key enrollment periods to be aware of:¹

Medicare Open Enrollment Period (October 15–December 7)
You can switch from Original Medicare (Part A and Part B) to Medicare Advantage (or vice versa), join or drop a Part D prescription drug plan or change Part C or D plans.
Medicare Advantage Open Enrollment Period (January 1–March 31)
If you’re already enrolled in a Medicare Advantage plan, this period lets you switch to a different Medicare Advantage plan or return to Original Medicare and join a Part D plan.
General Enrollment Period (January 1–March 31)
If you didn’t sign up for Medicare when you were first eligible, you can enroll in Parts A and/or B during this time. Coverage begins July 1, and late penalties may apply.
Special Enrollment Periods (SEPs)
Certain life events, like moving, losing employer coverage or qualifying for Extra Help, may allow you to make changes outside the standard enrollment periods.

Medicare supplement plans aren’t limited to these enrollment periods.

If you’re enrolled in a Marketplace plan, you’ll typically receive two letters by November 1—one from your insurer and one from the Marketplace. These will outline your coverage for the coming year, any changes, and whether you’ll be automatically re-enrolled if no action is taken. During Open Enrollment, update your expected income and household size to ensure you get the right savings and avoid surprises at tax time.²

How to assess your current Medicare coverage

Assessing your Medicare plan is a straightforward process that involves the following steps:

Check your Medicare card: Confirm your enrollment in Parts A and B to ensure your coverage is active.
Evaluate your healthcare needs: Consider any health changes, such as new diagnoses or treatments. Verify that your plan still covers necessary treatments, medications or specialists.
Review your healthcare costs: Look at your medical expenses from the past year and compare them with your plan’s premiums, deductibles and out-of-pocket costs to see if it remains cost-effective.³
Check your provider networks: Original Medicare and Medicare supplement plans are accepted by any provider that accepts Medicare patients because they don’t have specific provider networks. However, Medicare Advantage plans have networks, and if your doctor(s) are out of network, you may need to switch plans during the next AEP. Changes to supplement plans are not tied to the AEP, but may require underwriting and cancellation of your existing plan.
Check your pharmacy networks: Part C and Part D have their own pharmacy networks. If your current plan changes or you switch, review the pharmacy network to ensure your medications and preferred pharmacy are covered.
Use comparison tools: Resources like the Medicare Plan Finder can help you compare your current plan with others available in your area to identify the most suitable options.⁴

Signs you need to update your Medicare plan

You should consider updating your Medicare plan if you notice any of the following changes:

Changes in health or treatments: New health conditions or treatments that may require different coverage
New medications: Medications not covered by your plan or those that come with high out-of-pocket costs
Increased medical costs: Significant increases in premiums, deductibles, and/or other medical expenses.
Changes in Medicare Advantage’s provider network: Using out-of-network healthcare providers leads to higher out-of-pocket costs
Eligibility for additional savings: A change in financial situation that might make you eligible for Medicare or Extra Help for prescription drugs
Your household income or size has changed: This may affect your eligibility for savings or subsidies, particularly for Marketplace plans.²

Regularly reviewing your plan helps ensure that your coverage stays aligned with your healthcare needs and keeps costs manageable.

Reviewing your Medicare plan: What to consider

Medicare plans may change annually, so it’s essential to review your coverage to ensure it still meets your needs. The review process varies based on your plan type.

Medicare Advantage and Part D plans

If you’re enrolled in a Medicare Advantage or Part D plan, your provider will send you an Annual Notice of Change (ANOC) each fall. This document outlines any updates to premiums, benefits, provider networks (for Medicare Advantage plans) or drug coverage (for Part D plans).

Review your ANOC carefully to see whether:

Your providers are still in-network
Your prescriptions are still covered
Costs such as premiums or copays are increasing

Medicare supplement plans

Medicare supplement plans aren’t tied to annual enrollment periods. You can apply to change plans at any time. However:

Medical underwriting typically applies, and approval is not guaranteed.
If switching from a Medicare Advantage plan to a Medicare supplement plan, you may also face underwriting requirements.
Remember to always wait for approval of your new policy before canceling your current plan to avoid a potential lapse in your insurance coverage.
If trying a new Medicare supplement plan, a 30-day “free look” period may allow you to return to your original plan if you haven’t canceled it yet.⁵

Switching between plan types

If switching:

From a Medicare supplement insurance policy to a Medicare Advantage one, cancel your supplement policy only after your new plan takes effect.
From a Medicare Advantage plan to a Medicare supplement plan, be aware that approval may depend on your health unless you have guaranteed issue rights.

Step-by-step guide to updating your coverage

Breaking down how to update your Medicare coverage into smaller steps can help you make confident, informed decisions. Here’s how to review and adjust your Medicare plan:

Review current plan costs: Look at your premiums, deductibles and out-of-pocket expenses from the past year to assess cost-effectiveness.
Understand your options: Learn about the different coverages:
- Original Medicare (Parts A and B)
- Medicare Advantage (Part C)
- Part D prescription drug plans
- Medicare supplement insurance
Compare plans using the Medicare Plan Finder: Identify plans available in your area and see how they stack up based on coverage, costs and ratings.
Evaluate the costs and provider networks of new plans: When considering switching or updating, review premiums, copays and out-of-pocket limits. For Medicare Advantage plans, make sure that your preferred providers are in-network.
Review prescription drug coverage: Ensure that your medications are included in the plan’s formulary and that your preferred pharmacy is included as part of the plan’s current network (for Part D plans and Medicare Advantage (Part C) plans).
Submit your application during the appropriate enrollment period (if applicable): If you’re switching to or from a Medicare Advantage or Part D plan, you must submit your application during an enrollment window, such as the AEP; Medicare supplement plans can be changed at any time, but switching usually requires passing medical underwriting.
If you have a Marketplace plan: During the Medicare Open Enrollment period, review the open enrollment letter from your insurer and from the Marketplace. Update your application with any changes to income or household size so your savings are accurate.
Confirm your enrollment: After submitting your application to the insurer, verify your enrollment status and effective coverage start date to avoid any coverage gaps.

Get help reviewing your Medicare options

The Mutual of Omaha Medicare Advice Center offers personalized support to help you understand your coverage and make confident choices. You can also work with one of our benefits advisors for one-on-one help in reviewing your current plan and exploring new options.

Frequently Asked Questions

How often should I review my Medicare plan?

It’s a good idea to review your Medicare coverage every year, especially if you have a Medicare Advantage or Part D prescription drug plan, as these plans often change annually in terms of premiums, benefits and provider or pharmacy networks. While Original Medicare and supplement insurance plans tend to remain stable, it’s still worth reviewing your premiums, deductibles and out-of-pocket costs to ensure your coverage continues to meet your needs.

How do I know if I need to update my Medicare plan?

You may consider updating your plan if there are significant changes in your healthcare needs, if the costs of your current plan have increased, or if the benefits of your current plan have changed. If you find that your coverage no longer fits your needs, or if your plan doesn’t cover your medications or preferred providers, it may be time for an update.

Can I update my Medicare plan outside of open enrollment?

You can switch Medicare Advantage or Part D prescription drug plans outside of open enrollment if you qualify for a Special Enrollment Period (SEP), typically triggered by life events like moving, losing other coverage or qualifying for Medicaid or Extra Help. Medicare supplement insurance plans can be changed at any time of year but may require medical underwriting unless you qualify for guaranteed issue rights.

What factors should I consider when choosing a new Medicare plan?

When choosing a new Medicare plan, consider the costs (premiums, deductibles, copayments), coverage options (prescription drugs, specialist care), provider networks and whether your medications and healthcare providers are covered. Compare all these factors to find the best plan for your health and budget.

Do I need to switch my Medicare supplement plan yearly?

No, you don’t need to switch your Medicare supplement plan each year. These plans generally offer stable coverage, and switching plans may be subject to approval, which could limit your options or increase costs depending on the required underwriting. So, most people consider switching only if their current plan no longer meets their needs or becomes too expensive.

Expertly reviewed by: Dr. Manoj Pawar, MD, FAAP

Chief Medical Officer, Mutual of Omaha

Dr. Pawar brings over two decades of clinical and executive experience with a focus on preventive care, public health and empowering physicians and patients with the tools they need to live their best lives. Dr. Pawar completed his undergraduate degree at Northwestern University, his medical degree at McGill University in Montreal and his specialty training at the University of Colorado. He’s a Fellow of the American Academy of Family Physician and a member of Delta Omega, the Public Health honor society.

Footnotes:

¹ Medicare.gov. PDF: Remember Key Medicare Dates. Retrieved on July 15, 2025, from https://www.medicare.gov/publications/12192-remember-key-medicare-dates.pdf.

² Healthcare.gov. Web page: Keep or change your insurance plan. Retrieved on July 15, 2025, from https://www.healthcare.gov/keep-or-change-plan/.

³ Healthcare.gov. Web page: Comparing plans. Retrieved on July 15, 2025, from https://www.healthcare.gov/choose-a-plan/comparing-plans/.

⁴ Medicare.gov. Web page: Explore your Medicare coverage options. Retrieved on July 15, 2025, from https://www.medicare.gov/plan-compare/#/?year=2025&lang=en.

⁵ Medicare.gov. Web page: Can I switch or drop my Medigap policy? Retrieved on July 15, 2025, from https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/change-policies/switch-drop.

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