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Answering Questions About Medicare Coverage

Question: I turned 65 earlier this year and enrolled in Medicare and an additional Medicare Advantage Plan. When do I change my coverage again, when I turn 66 or is there another time?

Answer: Congratulations on making it through your Initial Open Enrollment Period (IEP) when you turned 65. That process can be overwhelming. Getting Medicare Part A & B started, and then reviewing all the possible plans in addition to that… It can be quite a process!!

Now you are in the same calendar year timeframe of all 67 million Americans with Medicare! That window includes an Annual Enrollment Period (AEP), which runs from October 15 to December 7 each year. During those 54 days everyone with Medicare has the opportunity to evaluate their coverage for the coming year and decide if they want to make a change. The change they make will begin January 1, 2026.

Right now, those insurance companies are working to develop their upcoming year plans and submit them to Centers for Medicare Services (CMS) for approval. Once they are set in ink, the insurance companies print up their material for 2026 and then send you notification of your plan’s offerings by September 30.

That notification is called the Annual Notice of Change (ANOC). When you receive your ANOC, you can review the material and decide whether or not you are happy with the plan.

Each and every year the plans change. Sometimes it is just a slight change, and sometimes the change can be pretty drastic. Last year we saw a number of insurance companies make some pretty drastic changes to their plans, including significantly higher premiums in some plans. Some carriers discontinued a number of their plans, so people had to get new insurance all together. You may have talked with individuals who were impacted by those changes.

It might seem early to start planning for the fall and next year, but these are the important timeframes you should be thinking about. If you are happy with your coverage now, enjoy that good coverage! It is always a good feeling to have insurance that you understand and feel is appropriate for your current situation.

But it is also important to understand that you should assume the plan changes in 2026, in some way. I hope that you understand you can always reach out to your insurance company to ask questions about your plan. If you use a broker, you should also get in touch with them.

You can also review materials that the plan sends to you throughout the year, indicating changes that might be happening – they might remind you about certain added benefits you may have forgotten you had, or which you never realized you had. It never hurts to go back through that initial enrollment material to review the plan benefits.

Most companies have very useful websites you can review as well. You can usually create a username and password on their sites, which would allow you to access your personal information related to claims and other benefits.

Then relax and enjoy the summer. Think about that fall, back to school time, as the time to start looking for more information about your plan for 2026. So, you can think about that going back to school as the time to get back into the insurance information. But if your insurance works for now, you can still enjoy summer!

The process is annual, but this year hopefully it will be easier, because you won’t ever have to go through the signing up for Medicare A & B again. Now you just review the current plan you have and compare it with others available to you. If you like your plan, will you still like it with the changes in 2026? Is there another company or plan offering something better? Is your situation different, and you require a different type of coverage? These are all things to consider in the fall so you can plan for 2026!

But right now, it is summer, so get outside and enjoy our outdoor season while it is here!

Janell Sluga is a Geriatric Care Manager helping seniors in our community access services and insurance. To reach her, please email editorial@post-journal.com.

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