Medicare Annual Review: What changes each year?
Medicare is not a one-and-done decision. Every autumn, insurance companies modify their provider networks, copayment amounts, and prescription drug formularies. A quick annual checkup ensures your plan still protects you.
Annual Medicare Timeline Every Texan Should Know
Federal regulations define strict calendar dates when beneficiaries can review notices and make adjustments to their coverage:
Late September
Annual Notice of Change (ANOC) Arrives
Your current Medicare Advantage or Part D plan insurer mails you the ANOC letter detailing every change to your plan’s benefits, premiums, copays, and prescription drug formularies starting January 1.
October 15 – December 7
Medicare Annual Enrollment Period (AEP)
The primary federal window for changing coverage. You can switch from Original Medicare to Medicare Advantage, change Medicare Advantage plans, switch Part D drug plans, or return to Original Medicare. New coverage takes effect January 1.
January 1 – March 31
Medicare Advantage Open Enrollment (MA-OEP)
If you are already enrolled in a Medicare Advantage plan as of January 1, you have a one-time opportunity during this 3-month period to switch to another Medicare Advantage plan or drop your plan and return to Original Medicare with a Part D plan.
The 4-Point Annual Notice of Change (ANOC) Audit
When your ANOC packet arrives in late September, do not throw it in the recycling bin. Review these four areas immediately:
Prescription Formulary Adjustments
Review whether your routine medications have shifted to a higher cost tier, been removed from the formulary, or now require step therapy or quantity limits.
Doctor & Hospital Network Retention
Confirm that your primary physicians, key specialists, and local Texas hospital systems are still contracted with your plan for the upcoming plan year.
Monthly Premiums & Deductibles
Check if your plan’s monthly premium, pharmacy deductible, or outpatient surgery copayments have increased for the new calendar year.
Maximum Out-of-Pocket (MOOP) Limits
Verify if your plan increased its annual out-of-pocket maximum threshold, which directly impacts your maximum financial exposure during a severe illness.
Confirmed Texas Medicare Carriers Represented
Fortify360 is contracted and authorized to represent top-tier national and Texas regional Medicare carriers.
UnitedHealthcare
Aetna
Cigna Healthcare
Humana
Devoted Health
Prominence Health Plan
Wellcare by CenteneFrequently Asked Questions About Annual Reviews
Do I have to change plans during AEP if I am happy with my coverage?
No. If you review your ANOC letter and your doctors, prescriptions, premiums, and benefits remain satisfactory, your plan will automatically renew on January 1. You do not need to take any action.
Can I change my Medigap policy during AEP?
AEP is a federal enrollment window specifically for Medicare Advantage (Part C) and Prescription Drug (Part D) plans. You can apply to change your Medicare Supplement (Medigap) policy at any time of the year in Texas, but unless you qualify for a Guaranteed Issue right, you will be subject to carrier medical underwriting.
How does Eric help during the Annual Enrollment Period?
Eric benchmarks your current plan’s new ANOC terms against all authorized options in your Texas county. If your current coverage remains the strongest choice, Eric will advise you to stay put.