Medicare Mistake #6: Keeping the Same Plan Without an Annual Review
Many people assume that if their Medicare plan worked last year, it will work again this year.
That assumption feels reasonable.
It’s also one of the most common Medicare mistakes.
Unlike many types of insurance, Medicare plans are allowed to change every single year—even if you make no changes at all.
What actually changes from year to year
Each fall, Medicare plans can update:
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Monthly premiums
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Copays and coinsurance
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Provider networks
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Prescription drug formularies
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Prior authorization rules
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Extra benefits and limits
These changes are legal, expected, and routine.
What’s not routine is people reviewing them.
The document most people never read
Every year, Medicare plans send out the Annual Notice of Change (ANOC).
This document explains:
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What will change on January 1
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What benefits are being reduced or removed
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What costs are increasing
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Whether the plan is renewing in your area
Most people:
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Skim it or ignore it
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Assume changes are minor
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File it away and forget it
By the time January arrives, the changes are already locked in.
“But my plan still looks the same…”
Many people don’t notice changes until they use their coverage.
Common surprises include:
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Higher copays at the doctor’s office
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Prescriptions moving to higher tiers
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A hospital no longer being in-network
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New referral or authorization requirements
At that point, the Annual Enrollment Period has usually passed—and options are limited.
Why this mistake is so costly
Skipping an annual review doesn’t just risk inconvenience. It can:
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Increase your total out-of-pocket costs
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Reduce access to doctors or specialists
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Force you to delay care
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Lock you into a plan that no longer fits your needs for an entire year
In some cases, staying on the wrong plan for years compounds these problems.
Medicare doesn’t automatically review plans for you
The official Medicare system (Medicare.gov) provides plan comparison tools, but it does not:
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Review your plan annually
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Alert you when your plan becomes a worse fit
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Compare your plan against new options
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Warn you when costs are about to increase
If you don’t review your plan, no one else will do it for you.
Annual review doesn’t mean annual switching
An annual review is not about changing plans every year.
In fact, many reviews end with:
“You’re still on the right plan.”
The value of the review is confirmation—not disruption.
A proper review answers:
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What changed?
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Does it affect me?
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Am I still protected if my health changes?
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Is my plan still competitive for my situation?
Sometimes staying put is the best choice—but only after verifying the facts.
When annual reviews matter most
Annual reviews are especially important if:
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You take prescription medications
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You see specialists regularly
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You had health changes during the year
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Your income or financial priorities changed
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Your plan added or removed benefits
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Your county gained or lost plan options
These factors can quietly turn a good plan into a poor fit.
The bottom line
Medicare is not “set it and forget it.”
Plans change. Costs change. Networks change.
And the consequences of ignoring those changes can follow you for years.
Before each new year begins, one question can protect you from unnecessary surprises:
“Is my current plan still the best fit for me next year?”
Asking—and answering—that question annually is one of the smartest Medicare habits you can build.
Coming next in this series
Medicare Mistake #7: Being Caught Off Guard When Your Plan Is Canceled
Real-World ANOC Examples: What People Actually Miss
Most Annual Notice of Change (ANOC) documents are 20–40 pages long.
The changes that matter most are often buried in the fine print.
Here are examples that happen every year.
🧾 ANOC Example #1: “My copays doubled overnight”
What the ANOC said:
“Primary care copayment increased from $10 to $25. Specialist copayment increased from $35 to $70.”
What the member experienced:
Same plan. Same doctors.
But every visit now costs significantly more.
Over the year, this member paid hundreds more without changing anything.
🧾 ANOC Example #2: Prescription coverage quietly changed
What the ANOC said:
“Certain medications have moved to different formulary tiers.”
What the member experienced:
A medication that cost $15/month is now $60/month — and requires prior authorization.
No warning at the pharmacy.
No reminder before January 1.
Just higher costs.
🧾 ANOC Example #3: Hospital system removed from the network
What the ANOC said:
“Changes to provider network participation may occur.”
What the member experienced:
Their preferred hospital system is no longer in-network.
They didn’t find out until:
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A specialist referral was denied, or
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A hospital bill arrived at a much higher cost
🧾 ANOC Example #4: Added authorization requirements
What the ANOC said:
“Additional utilization management requirements may apply to certain services.”
What the member experienced:
Procedures that were previously covered now require:
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Prior authorization
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Additional paperwork
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Delays in care
Coverage still exists — but access became more difficult.
🧾 ANOC Example #5: Plan exiting the county
What the ANOC said:
“This plan will not be offered in your area next year.”
What the member experienced:
If they didn’t act:
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They were auto-enrolled into a different plan
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Provider access changed
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Costs increased
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Choices were limited
Timing mattered — and many people didn’t realize it.
Why these changes are easy to miss
ANOCs are:
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Long
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Written in technical language
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Easy to skim past
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Often misunderstood
And while Medicare.gov requires these notices to be sent, no one ensures you understand how the changes affect you personally.
That’s why annual reviews matter.
