My Medicare health plan is changing — do I need to switch? No, not automatically. If your plan is still offered and you’re comfortable with the changes, your Medicare health plan will automatically renew.
You only need to act if you want different coverage or your plan is ending. This annual check-in is different from your Initial Enrollment Period — the window for initially enrolling in Medicare Part A and Part B. Once you’re enrolled, Medicare provides enrollment periods each year so you can review and adjust your coverage.
Still, review your Annual Notice of Change (ANOC) first. This letter, mailed each September, explains what’s different about your plan.
Many people skip it. Later, they find their copay has gone up, a prescription has moved to a pricier tier, or their doctor has left the network.
Here are five things to check before deciding whether to switch.
Two different letters can arrive during September each year, and they mean very different things.
According to KFF, many insurers are reducing Medicare Advantage offerings next year, and some are exiting entire counties. Check your mail carefully.
Takeaway: ANOC means your plan continues. Termination means you need new coverage.
Your Medicare provider network often matters more than your monthly premium. A low-cost plan isn’t a good deal if your doctor isn’t in it.
Check that these are still covered next year:
Networks differ by plan and location, not just by company. Two plans from the same insurer can have different doctors, so check using your exact plan name.
Agent tip:
“Don’t assume your doctor is in-network just because the plan name looks the same. Networks change every January, and throughout the year — call and confirm.”
Every Medicare Part D and Medicare Advantage Prescription Drug plan uses a formulary, a list of covered drugs sorted into cost tiers for your prescription drug coverage. Insurers adjust formularies each year as part of normal Medicare Part D changes.
Review your ANOC for:
If a medication changed, talk to your doctor before switching — they may know a lower-cost option.
Need help reviewing your plan? Call (623) 223-8884 to speak with a licensed insurance agent for a no-cost plan review.
No-cost, unbiased service
Compare all major plans and carriers
Local, licensed insurance agents with 25+ years of combined experienceAccording to the Centers for Medicare & Medicaid Services (CMS), Medicare rates plans from 1 to 5 stars each year based on member satisfaction, customer service, and access to care. A higher rating usually means better quality.
If your rating dropped below 3 stars, compare other options. A 5-star plan may qualify you for a special, year-round enrollment window.
A rating change alone isn’t cause for worry, but it’s worth a look after several years of decline.
Not every benefit change affects you. Plans adjust small details yearly that rarely affect your daily life.
Focus on benefits you personally use. A benefit you never use changing isn’t a reason to worry. Don’t switch because of headlines. Switch because something important to you changed.
Starting in 2026, some HMO and HMO-POS beneficiaries will need a primary care referral before seeing many specialists. Emergency care, OB/GYN, mental health, oncology, and radiology are exceptions. This is a process change, not a reduction in benefits. Ask your doctor’s office how referrals work under your plan.
When Should You Actually Switch Medicare Plans?
Every situation is different. What matters is whether the changes affect the care you need.
A changing Medicare health plan doesn’t automatically mean you should switch. Medicare renews your coverage automatically if your plan is still offered. The key step is reviewing your ANOC every September.
If changes affect your doctors, medications, or budget, compare plans. If not, staying enrolled is reasonable.
No-cost, unbiased serviceCompare all major plans and carriers Local, licensed insurance agents with 25+ years of combined experience
Yes. If your plan is offered next year and you make no changes, Medicare will automatically keep you enrolled.
An Annual Notice of Change (ANOC) is a letter mailed each September. It explains next year’s cost, benefit, and network changes. Review it every September to know how your plan may be changing.
You’ll get a Notice of Termination with a list of other plans in your area, plus a Special Enrollment Period and maybe a Guaranteed Issue Right to buy a Medigap policy.
Maybe. Provider networks change yearly and vary by plan, not just by company. Check your exact plan name against your doctor’s accepted insurance list before the Annual Enrollment Period ends.
Compare plans if your doctors left the network, your medications changed significantly, your plan is ending, or your star rating dropped. Minor benefit changes usually don’t require switching. If you’re unhappy with your plan, you can switch to a different Medicare Advantage plan or move to Original Medicare.
Read more by Renee van Staveren
Since 2009, I've been writing about complicated, technical issues, with the goal of making topics like Medicare and healthcare easier to understand. I've been writing about Medicare since 2021 and healthcare since 2019. I am an AmeriCorps alumni. I enjoy gardening, reading, and DIYing.
Call Now
