The Medicare Annual Enrollment Period (AEP) is currently open (only until December 7), and this time of year is critical for securing your health coverage for the next year. While most beneficiaries focus on new, enhanced benefits that plans often promote, it is essential—and often overlooked—to check for services that might be subtly removed or reduced.
For the 2026 coverage year, numerous Medicare plans are making significant adjustments behind the scenes. We are already seeing trends that include subtle contractions in some of the most popular supplemental benefits, such as coverage for dental, vision, or hearing services. Furthermore, many beneficiaries will face unexpected shifts in their prescription drug costs and tier placements, which can dramatically impact your annual healthcare budget.
The Critical 2026 Benefits Checklist: What to Scrutinize
If you have received your Annual Notice of Change (ANOC) letter, you cannot afford to set it aside. Waiting until you have a health need in January to discover a loss of coverage can lead to significant out-of-pocket expenses. Here are the most critical areas our advisors help clients check during AEP:
- Supplemental Benefits: Has the annual dollar allowance for essential services like dental, vision, or hearing been reduced? More importantly, has your plan switched to a different network, meaning your trusted provider is no longer covered? These small changes can result in large, unexpected costs.
- Part D Drug Costs (Formulary Changes): This is one of the biggest sources of surprise costs. Are your preferred medications—especially brand-name or specialty drugs—being moved to a higher copay tier? A simple reclassification on the plan’s formulary can quickly change a manageable copay into a major monthly expense.
- Provider Network Stability: Confirm that your plan still includes your entire care team—your primary care physician, specialists, and the hospital systems you rely on. Dropping a key provider forces you to choose between switching doctors or paying more out-of-network costs.
- Cost Sharing: Always check for changes to premiums, deductibles, and the maximum out-of-pocket limit. While a premium might stay the same, a change in your maximum out-of-pocket limit is a change to your ultimate financial risk.
Don’t Risk Surprise Bills: The December 7th Deadline
If your current plan is reducing benefits or increasing costs, you have a limited time—until December 7th—to switch to a plan that genuinely aligns with your health and budget needs for 2026.
You are welcome to visit the official Medicare website at medicare.gov to independently view and compare plans available in your area. However, navigating the complex Medicare AEP and interpreting the fine print of plan changes can be overwhelming.
Our experienced advisors at Clear Benefit Solutions are ready to help! We offer a no-cost, no-obligation review of your current coverage, compare it with all suitable local options, and ensure you make an informed decision. We provide the clarity and confidence you need to secure the best possible coverage.