How to Evaluate Whether Your Plan Still Fits Your Needs

Cassidy Clark

Oct 5

2 min read

With AEP underway, it's worth taking an honest look at whether your current plan still fits your needs for 2027. Here's how to review your coverage before making a decision.

Start With Your ANOC and EOC

If you have a Medicare Advantage or Part D plan, your insurer was required to mail you an Annual Notice of Change (ANOC) by September 30 [1].

It arrives alongside or shortly before your Evidence of Coverage (EOC). Together, these two documents lay out exactly what's changing in your plan for next year, including cost, coverage, and network updates [1].

If you haven't received or reviewed yours yet, it's worth pulling out now.

Check the Numbers That Matter Most

Read the ANOC side by side with what you're paying today and look specifically for changes to:

Monthly premium, if applicable
Annual deductible
Maximum out-of-pocket limit (for Medicare Advantage plans)
Copays and coinsurance for the services you use most

A small premium change can hide a much bigger shift in what you'd actually pay over the year, so look past the headline number.

Confirm Your Doctors and Pharmacies Are Still In-Network

Provider networks can change from year to year. Your SGIA Benefit Consultant can help you confirm that your preferred doctors, specialists, and facilities are still contracted with your plan for next year [2]. The same goes for your pharmacy, since a network change here can significantly affect what you pay for prescriptions.

Look Closely at Your Prescription Drug Coverage

Formularies (the list of drugs a plan covers) and drug tiers can shift from year to year [3]. Pull your current medication list and check whether each medication is still on the plan's formulary, whether any medication has moved to a higher-cost tier, and whether new coverage rules like prior authorization or quantity limits have been added.

Factor In Any Health Changes

Finally, think about the year you've actually had. New diagnoses, new medications, or planned procedures can all change what "the right plan" looks like for you going into next year, even if nothing about your plan itself has changed.

SGIA Can Help You Navigate AEP

Reviewing all of this on your own can feel overwhelming, especially with the ANOC's dense formatting. SGIA Medicare Consulting can walk through your ANOC and current coverage with you and help you decide what, if anything, needs to change.

Visit sgiamedicare.com/schedule-appointment or call 888-284-3314. We Make Medicare Simple.