The Annual Enrollment Period (AEP) is one of the most important times of year for Medicare beneficiaries. From October 15 through December 7, this window gives you the chance to review your coverage, make changes, and ensure your plan still fits your health and financial needs. This is also the time to enroll in Medicare Advantage (Part C) and Medicare Prescription Drug Plans (Part D). Here’s what you need to know to make the most of this critical period.

What is AEP?

The Annual Enrollment Period, commonly known as AEP, is the annual window during which Medicare beneficiaries can make adjustments to their Medicare coverage. This period is crucial for those looking to switch between Medicare Advantage plans, enroll in a new plan, or change their prescription drug coverage. All changes made during AEP take effect on January 1 of the following year.

For a detailed FAQ, visit this Medicare site.

Why is AEP Important?

AEP provides a valuable opportunity to reassess your Medicare coverage. Life circumstances, health needs, and plan options can change, so it’s important to review your current plan to ensure it still meets your needs. This is your chance to potentially save money, find better coverage, or switch to a plan that better suits your evolving health requirements.

Who Should Participate in AEP?

Even if you are currently satisfied with your Medicare plan, it’s a good idea to participate in AEP. Each year, plan benefits, costs, and provider networks can change. Evaluating your options annually ensures you are not missing out on better coverage or more affordable options. Additionally, those who are new to Medicare or are approaching eligibility should also take advantage of this period to explore their options. 

How to Prepare for AEP

1. Review Your Current Coverage

Start by taking a close look at your current plan’s benefits, costs, and provider network. Ask yourself: does this plan still fit my health needs and budget? Consider whether you’ve had changes in your health this year, such as new prescriptions, more frequent doctor visits, or ongoing treatments. If your plan no longer feels like a good match, it may be time to explore alternatives.

2. Compare Plans

Use the Medicare Plan Finder or other comparison tools to see what new options are available in your area. Look beyond just the monthly premium—pay attention to deductibles, copays, out-of-pocket maximums, and whether your medications are covered affordably. Even small differences can add up to big savings over the course of a year.

3. Understand Plan Changes

Each fall, your current plan provider will send an Annual Notice of Change (ANOC). This document outlines any changes in costs, benefits, or provider networks for the upcoming year. Reviewing it carefully is essential, because even if your plan feels right today, changes for next year could affect your access to care or increase your costs.

4. Gather Necessary Information

Before you start comparing, make a simple checklist of your healthcare needs. Write down all your current medications, including dosages, and note your preferred pharmacy. Include your doctors and specialists, too, since staying in-network helps keep costs down. If you anticipate any changes in your health, like upcoming surgeries or therapies, keep that in mind as you evaluate options.

5. Seek Assistance

You don’t have to navigate AEP on your own. Utilize resources like Medicare counselors, SHIP (State Health Insurance Assistance Program) counselors, and online tools. We also host events at our San Antonio clinic with broker partners and Medicare agents who can help explain changes and offer advice.

Common Mistakes to Avoid During AEP

1. Not Comparing All Available Options

Medicare Advantage and Part D plans change every year, and new options often become available in your area. By comparing all potential plans, rather than defaulting to what you already have, you may find one that offers lower costs, broader provider networks, or better coverage for your prescriptions. Taking the time to shop around could save you money and improve your access to care.

2. Failing to Read the Fine Print

Make sure you understand the details of any new plan, including out-of-pocket costs and coverage limits. A medication that’s affordable this year might move to a higher cost tier next year. Similarly, a preferred doctor or hospital could leave the network. Keeping an eye on the details helps you avoid unpleasant surprises in January.

3. Missing the Enrollment Deadline

The AEP window closes on December 7, and late changes generally aren’t allowed unless you qualify for a Special Enrollment Period. Missing the deadline can lock you into a plan that doesn’t meet your needs for the entire year ahead. 

FAQs About AEP

What can I change during AEP?

• Switch between Original Medicare (Parts A & B) and Medicare Advantage (Part C), and vice versa
• Change Medicare Advantage plans—either within the same company or to a different one
• Enroll in, switch, or drop a stand-alone Medicare Part D prescription drug plan
  Choose Original Medicare and add a Part D plan if needed

Am I eligible for Medicare Advantage?
As long as you’ve enrolled in Original Medicare (Part A and Part B), you’re eligible to join a Medicare Advantage plan (Part C) during AEP. These plans are offered by private insurers and often include extra benefits like dental, vision, and prescription drug coverage. 

Flagship Health accepts several Medicare Advantage plans. For a full list, visit our insurance page.

Can I switch from Medicare Advantage to Original Medicare?
Yes. AEP gives you the flexibility to leave a Medicare Advantage plan and return to Original Medicare. If you do, you can also enroll in a Part D prescription drug plan at the same time.

What’s IRMAA and will it affect me?
IRMAA (Income-Related Monthly Adjustment Amount) is a higher premium charged to Part B and Part D enrollees with higher incomes based on tax data from two years prior. You may appeal if your income has recently dropped due to life changes.

What changes to Medicare are coming in 2026 that I should know about?

• Part B and Part D premiums and deductibles are expected to rise (Part B up ~11.6%, Part D around 6%)
• A $2,100 Part D catastrophic threshold, up from the 2025 cap of $2,000
• The Inflation Reduction Act continues to offer capped insulin pricing and price negotiation for high-cost drugs. A new Prescription Payment Plan will provide automatic renewal for easier budgeting.
• Supplemental benefits in Medicare Advantage plans may be reduced next year

How much does Medicare Part D cost?

• Estimated base premium: around $38.99 per month, up from roughly $36 in 2025
• Deductible: expected to rise to approximately $615 in 2026, up from $590 in 2025
• Payment flexibility: the Medicare Prescription Payment Plan (MPPP) will continue and now includes automatic year-to-year renewal unless you opt out, making it easier to manage payments throughout the year

Making the Most of Your Options

Navigating AEP doesn’t have to be overwhelming. The key is to give yourself enough time, gather the right information, and compare your choices with care. By taking the time to review and update your plan, you can ensure that you’re getting the best possible coverage and value. 

As a primary care provider, we’re happy to support seniors through the annual enrollment period. While we don’t sell Medicare plans, we do work with patients to ensure your care needs are fully supported. Our team can help you understand how your healthcare needs align with your plan, guide you toward trusted resources for plan comparisons, and provide ongoing care that keeps you healthy year-round.

With the right preparation—and a trusted care team by your side—you can approach AEP with peace of mind and focus on what matters most: your health and well-being.