Flagship Health | Medicare Annual Enrollment: Why It Matters

The Medicare Annual Enrollment Period (AEP) is well underway. From now until December 7, anyone who is Medicare-eligible — including Americans aged 65 and older, as well as those with certain disabilities — can review and select a health plan that best aligns with their needs.

Medicare Advantage plans, offered by private insurance companies, can enhance your health and wellness by providing comprehensive coverage options. Many of these plans also have built-in cost-saving features, such as caps on out-of-pocket expenses for services and prescription medications. Some plans eliminate copayments for primary care visits, allowing you to see your doctor without extra costs.

Additional benefits often available with Medicare Advantage plans include coverage for dental, hearing, and vision care. Some plans also offer added perks, such as gym memberships, discounts on healthy food and over-the-counter medical items, and even the "Giveback Benefit," where certain plans contribute to members' Medicare Part B premiums.

Why AEP Matters

For many seniors, it’s easy to stick with “what I’ve always had” because you’ve been comfortable with your current plan. But the reality is your health needs, financial situation, and plan offerings change over time. The Annual Enrollment Period gives you a once-a-year chance to make sure your coverage still fits you.

Here are a few reasons to make the most of AEP:

Your Health May Have Changed

As we age, our health circumstances often shift. Perhaps you need more frequent doctor visits, new medications, or a specialist that wasn’t previously part of your care team. AEP allows you to switch to a plan that better matches your current health needs.

Medications and Drug Lists Change

Many Medicare plans update their prescription drug lists (formularies) each year. That means medications you take today may not be covered tomorrow, or may move to a higher cost tier. Carefully reviewing prescription drug coverage during AEP can help you avoid surprises at the pharmacy.

Doctors and Hospitals May Move Out of Network

If you have a favorite doctor, specialist, or hospital, it’s important to check that they remain in your plan’s network. Some insurance companies change their contracts from year to year, which can mean higher costs for the same care. AEP gives you a chance to switch to a plan that keeps your trusted providers.

Costs Can Go Up

Even if nothing about your health changed, your plan premiums, deductibles, copays, or out-of-pocket limits might increase. If you don’t review, you may end up paying more than you need to or missing out on benefits.

It’s Your Once-A-Year Opportunity

For most Medicare beneficiaries, this annual window is the only time you can make most changes for the upcoming year. If you miss this window and your needs shift, you may have fewer options until the next year (unless a special situation applies).

By taking a few hours to review your plan now, you’re taking an important step toward reducing worry, avoiding surprise costs, and making sure you’ll be covered when it counts.

Steps to Take During the Annual Enrollment Period

1. Start with Medicare.gov

Visit the official Medicare website and enter your zip code to explore the available Medicare Advantage plans in your area. This is a good starting point to see a list of options.

2. Gather Key Information

A list of your current medications and dosages
Names of your preferred doctors, pharmacies, and hospitals
How you’ve used care this past year (doctor visits, hospital stays, etc.)

3. Use the Info Above to Compare:

Plan premiums, deductibles, copays, out-of-pocket maximums
Whether your doctors/hospitals/pharmacy are in-network
Whether your medications are covered and at what cost-tier
Any extra benefits you value (dental, vision, hearing, fitness)

4. Seek Guidance from an Expert

Medicare can feel complex, so consider reaching out to a trusted local broker or community advisor for help. They can walk you through different plans and answer questions to make sure you’re well-informed.

Make sure you complete AEP by the deadline of December 7 to get coverage for the next calendar year!

Your Trusted Partner in Senior Primary Care

At Flagship Health, we understand that every healthcare decision, including your insurance plan, impacts your wellbeing. While we are a primary care provider for seniors and veterans, not an insurance provider, we frequently partner with brokers to help ensure you get the care you need.

For more information, attend any of our free informational sessions on AEP, Medicare, and Medicare Advantage. These events feature trusted, physician-approved brokers who can answer all your questions and help you choose the plan that is best for you.