How often should I review my plan to make sure my therapy is still covered?

Question

Daniel Brechin · Accepted Answer

It depends.  As an agent I call or try to everyone my clients to answer any questions.   I am always at phone call to help.  However,  there will be something 
That I cannot control and you will have to call the Insurance company

Mark Maliwauki · Answer

Once per year should be enough. Medicare plans don't change their benefits mid-year so once a plan goes into affect on January 1st, it will be good for that entire calendar year.

Michael Denniston · Answer

My advice is to use the AEP （Annual Enrollment Period) between 10 15 and 12 07 each year to search all available plans to see if you are covered to match your needs and services for the next fiscal year.

Answered by Michael Denniston on December 22, 2025

Agent Licensed in FL, AL, AR & 11 other states

Answered by Michael Denniston Medicare Insurance Agent

Mike Odle · Answer

I don't know that I fully understand by "review". The therapy provider will have to document continued improvement from whatever therapy it is that you're receiving in order for it to continue to be covered, whether that's on an outpatient basis, or in a rehab facility. This is what's proving to the payer that what you're receiving is continuing to be medically necessary. If the provider fails to demonstrate to the payer that you're continuing to make improvement, the coverage will stop.

Answered by Mike Odle on November 30, 2025

Broker Licensed in IN & IL

Answered by Mike Odle Medicare Insurance Agent

Samantha Jellison · Answer

Each and every year, during Annual Enrollment Period. Whether you have been on your current plan for a year or 10, every Medicare Advantage plan has the opportunity to change their benefits from year to year. This also goes for formularies as well. It is important to do an annual review during this time for the upcoming year to be sure your needs will align with what your plan is offering. Your provider may have left the network, your prescriptions may no longer be covered, your deductibles or co-payments may have gone up significantly. It is better to check during this time for the upcoming year than it is to receive an unwanted surprise at the beginning of the new year. If they no longer align with what you need, this is the time to make a plan change for the upcoming year.

Answered by Samantha Jellison on November 23, 2025

Broker Licensed in NC, FL & SC

Answered by Samantha Jellison Medicare Insurance Agent

Karen Murray · Answer

It’s a good idea to review your coverage at least once a year, especially during Medicare’s Annual Enrollment Period (October 15 – December 7). Plans can change their provider networks, therapy coverage, and costs each year.

You should also review your plan anytime your health needs change or if your therapist or provider tells you they may no longer be in your plan’s network.

Michael McGarrigle · Answer

At a minimum, I recommend reviewing your plan once a year—usually during the Annual Enrollment Period.

That said, if you’re actively in therapy or your treatment changes, it’s worth taking another look sooner. Networks, coverage rules, and authorizations can change, and you want to make sure your providers and services are still covered the way you expect.

Also, if you have a qualifying chronic condition, there may be Chronic Special Needs Plans available, and those can often be joined outside of the normal enrollment periods.

It only takes a quick review to catch issues early and avoid surprises.

Tommy Overton · Answer

Great question. It depends upon what type of plan. If have Medicare Advantage, review it during any available enrollment period including the Annual Enrollment Period from October 15 - December 7 as well as the Open Enrollment Period, which is January 1 - March 31. If you have a Medicare Supplement then you can review it any time of the year and change to a lower cost plan, if you qualify.

Answered by Tommy Overton on November 27, 2025

Broker Licensed in AR, AL, IN & 7 other states

Answered by Tommy Overton Medicare Insurance Agent

Ron Cronwell · Answer

Once a year during AEP. Also review yor ANOC which you receive in late September for the next year.

You should also verify with your therapist to ensure they remain in network.

Nancy Courser · Answer

You should review your plan changes during the Annual Election Period in the fall which runs 10/15 - 12/07 for a January 1st start date. You can then ascertain if a specific therapy is covered and what the potential co-pay/so-insurance might be.

Answered by Nancy Courser on May 18, 2026

Agent Licensed in MI, FL & TN

Answered by Nancy Courser Medicare Insurance Agent

Lee Hampton · Answer

Plan benefits only change annually. The new plan benefits take effect on January 1st. You should review your plan each year during the Annual Enrollment Period starting in October. 

Your current plan will send you A Notice of Change (ANOC) letter by the end of September. It is important to review this letter as it will highlight the changes to your plan benefits for the following year.

Kim Humphries · Answer

If you are on an advantage plan, your "Annual Notice of Changes" will arrive in the mail or via email inbox in September. Do not ignore, read it and keep up with the plan changes each year. Call your agent and ask questions. Advantage plans can change every year. Kim Humphries

Answered by Kim Humphries on November 23, 2025

Broker Licensed in FL & IN

Answered by Kim Humphries Medicare Insurance Agent

Meghan Blankenship · Answer

You should review your Medicare plan at least once a year, especially during the Annual Open Enrollment Period (October 15-December 7), to make sure therapy services are still covered.

Dean Chiapetto · Answer

You should review your plan on a yearly basis and make sure that you check if your therapy in network and make sure you are covered.

Carol Conner · Answer

You should have your plan viewed every year because they change and depending on if you have a Medicare supplement or Medicare advantage that could make a big difference so again you should review your plans yearly

Answered by Carol Conner on November 23, 2025

Broker Licensed in TX

Answered by Carol Conner Medicare Insurance Agent

Adam Ernst · Answer

If you have an agent, give them a call and they will go over it with you. If you are on a MA plan, you would have to contact the carrier to find out about that. You can always call the doctor/practice that is administering your therapy to see what Medicare is covering.

Answered by Adam Ernst on November 23, 2025

Agent Licensed in NC, SC & TN

Answered by Adam Ernst Medicare Insurance Agent

Amal Sahyoun · Answer

You should review your plan once per year around October to see what changes there may be coming up for the following year.

Tetonya Lewis Charles · Answer

Since the Coverage in plans change every year, it is advisable to review your plan each year during the annual enrolment period mid October to December 7th for each upcoming new year to begin January 1.  This also gives you the opportunity to check on other benefits you can take advantage of. 

In Addition to checking your therapy coverage, check your prescription formulary for your Rx coverage and that your doctors still accept the plan or still in network when on a Medicare Advantage plan.  This way you won't be surprised come next year when things change, and you let your plan roll over without checking

Margaret Winter · Answer

To make sure your therapy is still covered, you should review your plan annual notice of change each year to verify coverage. Each year during Annual Enrollment Period, you have the ability to review other plans to determine if therapy is covered and what the co-pays and co-insurance may be.

Answered by Margaret Winter on May 28, 2026

Broker Licensed in WI

Answered by Margaret Winter Medicare Insurance Agent

Tiera McQuater · Answer

I always recommend reviewing your Medicare plan at least once a year to make sure your therapy services and providers are still covered properly. This is especially important if you receive ongoing physical therapy, occupational therapy, speech therapy, behavioral health services, or other specialized care.

Insurance plans can change from year to year, including provider networks, prior authorization requirements, copays, visit limits, and coverage guidelines. Reviewing your plan annually can help avoid unexpected costs or interruptions in care.

You should also consider reviewing your coverage anytime:

* Your therapy needs increase or change
* Your therapist or facility leaves the network
* Your out-of-pocket costs increase
* Your doctor recommends new treatments or specialists
* You receive your Annual Notice of Change (ANOC) from your insurance carrier outlining upcoming plan changes

My goal is to help clients not only select the right plan initially, but also continue reviewing their coverage over time to help ensure they maintain access to the care, therapy, and support services that are important to their health and quality of life.

Jill Runyan · Answer

Each year, I consult with my clients, and we review all health conditions and prescribed therapies to best ensure they have coverage as needed.  Everyone should review benefits at least annually.

How often should I review my plan to make sure my therapy is still covered?

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How often should I review my plan to make sure my therapy is still covered?

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