What Is AEP Medicare [Tips + Strategies for Evaluation]

Medicare’s Annual Enrollment Period (AEP) is one of the most important times of the year (October 15 th – December 7 th ) for beneficiaries looking to adjust their healthcare coverage.

Still, many Medicare beneficiaries miss opportunities to potentially save money or improve their benefits simply because they’re unaware of their options.

If you’re enrolled in Medicare Advantage or Part D, AEP is your chance to evaluate your current plan, compare new options, and ensure you have the best coverage for your needs.

In this guide, we’ll walk you through essential AEP tips, covering cost-saving strategies, plan comparison tools, and key deadlines to keep in mind.

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The Medicare Annual Enrollment Period (AEP) is a time frame where Medicare beneficiaries review and may make changes to their healthcare coverage.

During this period, you can:

Switch from Original Medicare to a Medicare Advantage plan (or vice versa). Change from one Medicare Advantage plan to another. Enroll in, drop, or modify a Part D Prescription Drug Plan to better match your medication needs. Decisions you make during AEP this year will take effect on January 1 of the following year, making AEP the ideal time to reassess your coverage and check if it aligns with your healthcare needs and budget.

This period matters because even if you’re happy with your current plan, reviewing any changes in premiums, provider networks, or drug formularies can help you avoid unexpected costs or coverage gaps in the upcoming year.

Preparing for Medicare AEP: What You Need to Do First Medicare’s Annual Enrollment Period (AEP) is your once-a-year opportunity to evaluate your coverage and make necessary adjustments for the coming year.

Here’s how to get started:

1. Review Your Current Coverage and Costs Before making any changes, take a closer look at your existing Medicare plan.

Ask yourself:

Are my premiums, deductibles, and copays still affordable? Has my plan’s coverage changed for the new year, particularly for prescription drugs or provider networks? Do I anticipate additional healthcare services next year that my current plan may not cover? Tip: Review your Annual Notice of Change (ANOC) , which details any modifications to your plan’s costs, benefits, and provider networks for the upcoming year.

2. Check if Your Doctors and Medications Are Still Covered Medicare Advantage and Part D plans often change their provider networks and drug formularies each year.

Make sure:

Your preferred doctors, specialists, and hospitals are still in-network. Your prescription medications remain covered under your Part D or Medicare Advantage plan. You understand any new coverage restrictions like prior authorizations or tier changes for medications. Tip: Contact your healthcare providers directly to confirm they are still in-network for the upcoming year.

3. Compare Medicare Advantage and Part D Plan Options Even if you were satisfied with your current plan in the previous year, it’s worth exploring other options to check if you're still getting the best value.

Before sticking with your current plan, take time to:

Look beyond premiums — consider copays, deductibles, and out-of-pocket maximums to assess total costs. Compare additional benefits of new plans that weren’t available in previous years. Consider different types of plans (Medicare Advantage vs. Original Medicare + Medicare Supplement + Part D) based on your changing healthcare needs. Tip : If you're considering switching to a new plan, compare premiums, out-of-pocket costs, supplemental benefits, and provider networks.

Strategies for Evaluating Medicare Plans in 2026 Selecting the right Medicare plan for your needs during AEP 2026 requires a thoughtful approach.

Key strategies you can use this year to evaluate plans are:

1. Use Online Tools for Plan Comparisons Navigating Medicare plans can be overwhelming, but online resources make the process easier.

Healthpilot’s personalized recommendations: Instead of sorting through countless plans, get customized options based on your doctors, medications, and healthcare needs. Tip: When comparing plans online, have a list of your current prescriptions and preferred doctors handy to check if they are covered in the new plan.

2. Understand Plan Features Beyond Premiums Many beneficiaries focus on monthly premiums, but that’s just one piece of the puzzle.

When evaluating a plan, also consider:

Deductibles and out-of-pocket maximums: How much will you need to pay before your coverage kicks in? Copayments and coinsurance: Will your costs for doctor visits, specialist appointments, and prescriptions remain affordable? Extra benefits: Some Medicare Advantage plans offer additional benefits — it's worth taking a look. Tip: If a plan has a low premium but high deductibles and copays, you may end up paying more out of pocket throughout the year.

3. Analyze Star Ratings for Plan Quality The Centers for Medicare & Medicaid Services (CMS) assigns star ratings (1 to 5 stars) to Medicare Advantage and Part D plans based on quality and member satisfaction.

These ratings reflect:

Customer experience and satisfaction Quality of healthcare services Drug safety and pricing transparency What to look for:

4+ star plans generally indicate strong customer support and quality healthcare access. Lower-rated plans may have more complaints, limited provider networks, or poor customer service. Tip: Choosing a highly rated plan sometimes means you may get better support, may have fewer claim issues, and potentially receive overall improved healthcare management.

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Tips To Maximize Cost Savings During AEP Medicare costs can change every year, so taking a proactive approach during AEP can help you save money while maintaining the coverage you need.

To help save money, you should:

1. Evaluate Plan Structures Before deciding on a plan, always:

Compare total costs: Look beyond just the premium — factor in deductibles, copays, and coinsurance to assess overall affordability. Check provider networks: Some lower-cost plans may have limited doctor networks. Verify that your preferred physicians and specialists are included. Analyze prescription drug coverage: If you take medications, check that they are covered under the plan’s formulary at a reasonable cost. Extra tip: A plan with a higher premium but lower out-of-pocket costs may be a better financial decision if you frequently visit doctors or take prescription medications.

2. Explore Assistance Programs for Low-Income Beneficiaries If you’re concerned about affording Medicare costs, you may qualify for financial assistance programs that help cover premiums, deductibles, and prescription drug costs.

Medicare Savings Programs (MSPs) : Helps with Medicare Part A and Part B costs for eligible low-income beneficiaries. Extra help for prescription drugs : Lowers out-of-pocket costs for Medicare Part D plans, including copays and deductibles. State Pharmaceutical Assistance Programs (SPAPs) : Some states offer additional assistance for medication costs — check if your state participates. Extra tip: Even if you didn’t qualify for financial assistance last year, income limits may have changed in the new year — it’s worth checking again!

3. Review Annual Notice of Change (ANOC) for Savings Opportunities Each year, Medicare beneficiaries receive an Annual Notice of Change (ANOC) from their plan provider, detailing upcoming changes to costs and benefits.

Before deciding on a plan, you should review:

Premium increases : Are your monthly costs rising? If so, it might be time to switch plans. New or removed benefits: Make sure your prescription drugs, specialists, or services are still covered at the same cost. Deductible and copay adjustments: Small increases can add up — compare new costs to similar plans. Extra tip: Set a reminder to review your ANOC as soon as it arrives in September. If your costs are increasing, AEP (October 15 – December 7) is your chance to find a more affordable plan.

The ANOC isn’t just about higher premiums — subtle changes in cost structures, provider networks, and drug formularies could cost you hundreds or even thousands of dollars over the year

Get More Tips About AEP With Healthpilot At Healthpilot, we're here to guide you every step of the way so you can make the best decision possible.

Until October this year, you have more than enough time to review your plan, explore new options, and check that your current coverage meets your evolving needs.

Healthpilot makes the process easier by offering:

Personalized recommendations: Get plan recommendations tailored to your doctors, prescriptions, and healthcare priorities. Easy-to-use comparison tools: Review different plans side by side to evaluate costs, benefits, and coverage options. Expert guidance when you need it : Our licensed, non-commissioned professionals are available to answer your questions. Convenient online enrollment: Enroll in the plan that works best for you, completely online and at your own pace. Ongoing plan reviews: Medicare plans change each year, and so do your healthcare needs. We’ll help you stay on top of important updates. Making the right Medicare decisions doesn’t have to be stressful. Healthpilot is here to simplify the process and give you confidence in your coverage choices.

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