What are the signs that it's time for me to switch my Medicare plan, and how often should I review my options?

Question

Taylor Langlois · Accepted Answer

There's three signs I always tell people it's time to go shopping for other options:
1) Cost changes (prescriptions, copays, premiums, etc.)
2) Health changes like new meds or complications
3) Doctor changes
I'll also throw in if your benefits change on your coverage. Those are all reasons I'd want to review my coverage to see if anyone is offering better.

That being said, I will always tell people that a good time to check your coverage is at least once a year. Typically we do that review with our clients anyways.

Larry Dalton · Answer

Medicare supplement/Medigap plans are good for life and cannot be canceled except if you fail to pay the premium. Do your homework or work with an agent you trust. They can assure you which Medicare supplemental/Medigap insurance to choose by analyzing records of these insurance companies' rates, showing their annual premium increases. Changing Medicare supplements midstream may be impossible if you develop health issues after turning 65. However, there is a one-time birthday rule in Oklahoma that you can use to make changes without underwriting requirements. Or you could always change to a Medicare Advantage plan during the annual enrollment dates.

Answered by Larry Dalton on March 27, 2025

Broker Licensed in OK & TX

Answered by Larry Dalton Medicare Insurance Agent

Christopher Palazzini · Answer

You should review your plan every year during AEP. 

Some signs are decrease in coverage, networks, increase in out of pockets, loss of benefits and RX hikes.

Phillip Lovelady · Answer

Signs that it’s time to switch your Medicare plan include:

Rising Costs: If your out-of-pocket expenses—like premiums, deductibles, or copays—are creeping up beyond what’s comfortable, a different plan might save you money. For example, a Medicare Advantage plan could cap your annual spending, unlike Original Medicare.

Changing Health Needs: If your doctor says you need new treatments, specialists, or meds that your current plan doesn’t cover well (or at all—like dental or vision in Original Medicare), it’s a red flag. A plan that once fit might not anymore.

Provider Network Issues: If your preferred doctors or hospitals drop out of your plan’s network (common with Medicare Advantage), or you move to a new area, you might need to switch to keep care seamless.

Poor Coverage Fit: Maybe you’re overinsured—paying for bells and whistles you don’t use—or underinsured, scrambling to cover gaps. A plan tweak could align better with your reality.

Plan Changes: Every year, plans adjust. Your Medicare Advantage or Part D plan might hike premiums, cut benefits, or alter drug formularies in ways that hit you hard. The Annual Notice of Change letter (sent by September 30) will tip you off.

As for how often to review your options: once a year is the sweet spot. The Annual Enrollment Period (AEP)—October 15 to December 7—lets you switch Part D or Medicare Advantage plans, or jump between Advantage and Original Medicare, with changes kicking in January 1. Even if you’re happy, skimming your plan’s updates during this window keeps you from getting blindsided. Life shifts—like a new diagnosis or move—might warrant an extra look, and Special Enrollment Periods (SEPs) can pop up for those (e.g., losing employer coverage). Medicare’s website or a quick call to 1-800-MEDICARE can help you compare. Don’t sleep on it—plans evolve, and so do you.

Patrick Hecht · Answer

A good rule of thumb is to review your Medicare plan every year during the Annual Enrollment Period from October 15 - December 7, even if everything seems fine. Things can change with plans, like premiums, drug formularies, provider networks, and out-of-pocket costs. Even small shifts in coverage or costs can add up, so it's smart to do a yearly check-up with an independent agent. I can help you compare your current plan with new options to make sure you're still in the best spot for your health and your wallet.

Answered by Patrick Hecht on May 19, 2025

Broker Licensed in VA, CA, MD, PA & WV

Answered by Patrick Hecht Medicare Insurance Agent

Voss Speros · Answer

You should review your options at minimum once every year.  What are the sings... you ask? Here is a question for you, has anything changed in your life or health over the past 12 months or since your last review? 

If not then you're probably good. If something is different then you need to give us a call and review your plan. There are hundreds of plan options available to you. 

Make sure to utilized everything that is available to you and double check to be sure.

Luis Daza · Answer

Your doctors are no longer in network, or your meds are no longer covered or too expensive. You must review your benefits twice yearly, first during the AEP from October to December each year and then during OEP from January to March.

Answered by Luis Daza on March 7, 2025

Agent Licensed in FL, CA, CO & 8 other states

Answered by Luis Daza Medicare Insurance Agent

Leslie Helene Sussman · Answer

As a Medicare Broker I communicate with my members on plan changes, updates and suggest checking in for plan reviews as changes can happen every year.   Annual Enrollment (October 1st - December 7th) is a time to review the new plans for the upcoming plan year.    
My goal for my members is to truly have their Medicare plan work for them the best way possible based on medical concerns and Prescriptions.  
I also make sure my members know about state and local resources available.      State programs are Income based and can provide assistance to out of pocket costs.

Jill Belvin · Answer

If you have Medicare Advantage or prescription drug coverage you should always look at your Medicare plan annual notice of change document that is sent annually to review any changes in your plan. If your plan has made substantial changes that will directly affect you it is a good idea to review the plan and compare to alternative plans.

Answered by Jill Belvin on March 24, 2025

Agent Licensed in TX, AZ, FL, MI & NJ

Answered by Jill Belvin Medicare Insurance Agent

Bill Zeky · Answer

I reach out to my customers prior to annual enrollment each year to offer them to review their plan. Because pricing and coverage levels change each year, reviewing coverages annually is very important. Plus, needed prescriptions and overall health and your finances can easily change from year to year. Annual reviews are a must.

Answered by Bill Zeky on May 19, 2025

Broker Licensed in PA, AL, CO & 10 other states

Answered by Bill Zeky Medicare Insurance Agent

Peter Yeh · Answer

Four signs you need to change your Medicare Part D coverage. 
1. Your current plan’s formulary has changed
2. Your medication needs have changed
3. The pharmacies included in your plan’s network aren’t convenient
4. You’re paying a high premium for a plan you’re hardly using

If you're paying a high premium for a prescription drug plan you're hardly using, it might be time to consider a switch.

Gary Henderson · Answer

Price increases over time will drive up the cost of medicare supplement plans. Review every 2 years.
Medicare advantage plans, if you are finding your doctors are leaving those plans.
Prescription drug plan if they are moving you to a more expensive plan or your prescription needs have changed recently.

Vachik Chakhbazian · Answer

include changes in your health status, changes in your medication list, concerns about plan costs, or changes in your plan's benefits.

Jaye Maxx Alexander II · Answer

The best time to review your coverage is twice a year, and if you have any major medical, dental procedures that are within a 90-day window, so that you are aware of the coverage and the cost, i.e., of out-of-pocket expenses and co-payment or co-insurance. If you have any major life-changing events, such as moving to a new city, county, or state.

Answered by Jaye Maxx Alexander II on May 2, 2025

Broker Licensed in NC, AK, AL & 47 other states

Answered by Jaye Maxx Alexander II Medicare Insurance Agent

Adam Ashby · Answer

Let's answer the second question first - you should review your options every year. EVERY YEAR. Medicare is changing and you need to stay informed. You will receive an Annual Notice Of Change from your provider - let an expert review that with you. Some of the signs that you may need to switch plans is your health. With health changes comes the need to ensure your coverage puts your main needs as you main protection.

Answered by Adam Ashby on May 19, 2025

Broker Licensed in CO, NE, UT, WA & WY

Answered by Adam Ashby Medicare Insurance Agent

Jason Kirschner · Answer

Whether you're facing rising costs, changing medical needs or a plan that no longer covers your prescription or doctors, it may be time to consider switching. Medicare offers several opportunities to change plans. Understanding when and how to switch can help you avoid unexpected expenses and ensure you receive the best possible care.

Answered by Jason Kirschner on May 14, 2025

Agent Licensed in FL

Answered by Jason Kirschner Medicare Insurance Agent

Heith Huguet · Answer

Changes in your health could be a sign. There may be a chronic condition plan in your area that you may now qualify for. Financial changes in your life could also be a sign. You may qualify for extra help based on your income. You should review the plan you are on annually. Plans change and what was once the right plan for you, may not be the right plan going forward.

Answered by Heith Huguet on May 22, 2025

Broker Licensed in LA & MS

Answered by Heith Huguet Medicare Insurance Agent

What are the signs that it's time for me to switch my Medicare plan, and how often should I review my options?

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