Annual Medicare Review Checklist

Medicare isn't set-and-forget, and the one fall window where you can switch plans without penalty is the cheapest hour you'll spend all year.

Why does a Medicare plan that fit you perfectly slowly start costing you money? Because the plan changes every year and you don’t. Insurers reshuffle formularies, premiums, and networks each fall, and the plan that was right at signup quietly drifts out of fit. The Annual Election Period, roughly October 15 to December 7, is your one clean window to fix it with no medical underwriting. Most people skip it. Don’t.

Here’s the review to run every fall before the window closes.

Read your plan’s annual notice

Open the Annual Notice of Change your plan mails each fall. It spells out next year’s premium, deductible, copays, and formulary changes.
Flag anything that moved against you: a higher premium, a drug bumped to a worse tier, a doctor dropped from the network.

Re-shop your drug plan around your actual medications

List every prescription with its dose.
Run that list through the plan finder at Medicare.gov to see the all-in cost, premium plus copays, for each Part D plan.
Switch if another plan covers your real drugs cheaper. The lowest premium is rarely the lowest total cost.

Check your coverage type still fits

If you’re on Medicare Advantage, confirm your doctors and hospitals are still in network for next year and re-weigh the access tradeoffs.
If you’re on Original Medicare with a Medigap supplement, confirm the premium and that the plan still suits how you actually use care.

Project your income and watch the IRMAA cliffs

Estimate this year’s income, because it sets your IRMAA surcharge two years from now.
If a Roth conversion, a large RMD, or a capital gain is about to push you over a bracket line, size it on purpose or use a Qualified Charitable Distribution to stay under.
If your income dropped from a life event like retirement or a spouse’s death, look into filing Form SSA-44 to appeal the surcharge.

Confirm the rest of the plan still holds

Verify your HSA reimbursements and any premium payments are squared away for the year.
Glance at your broader healthcare budget, including the dental, vision, and hearing costs Medicare won’t cover.

Medicare rewards the person who spends one hour each fall and quietly overcharges everyone who doesn’t. Put it on the calendar in October, and treat it like the high-paying chore it is.