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Annual review preparation

Medicare Advantage Annual Review Questions

A useful annual review checks what changed, what still fits, and which details require confirmation. It does not begin with the assumption that everyone should change plans.

Begin with the plan notice

Read the Annual Notice of Change

Medicare Advantage and Part D plans send an Annual Notice of Change that explains changes expected for the coming year. Review it with the current Evidence of Coverage and other plan materials.

Look for changes to costs, covered services, provider access rules, prior authorization rules, prescriptions, pharmacies, and service areas. If something is unclear, confirm it directly through current plan information or Medicare.gov before making a decision.

Questions worth asking

Review the parts of coverage you use

Providers and facilities

Are the doctors, specialists, hospitals, clinics, and other providers you expect to use participating for the coming plan year? Provider status can change, so verify it rather than relying on last year’s experience.

Prescriptions and pharmacies

Are your medications on the current prescription coverage list? Do tiers, restrictions, prior authorization, step therapy, quantity limits, or pharmacy status affect how the coverage may work?

Costs

Review the monthly cost, deductibles, copays, coinsurance, and the plan’s applicable out-of-pocket limit. Compare the categories that matter to your expected use rather than one number alone.

Access and rules

Understand provider access, referral, authorization, service-area, travel, and emergency or urgent-care rules. Ask how care outside your usual area is handled.

Additional coverage

Review only coverage details shown in current official plan documents. Availability, limits, conditions, providers, and value can vary and should not be assumed from advertising.

Personal changes

Consider changes in health-care use, prescriptions, providers, residence, travel, finances, caregiving needs, or preferences. Keep sensitive details for a secure private review.

Use the correct enrollment period

The annual period and Medicare Advantage Open Enrollment are different

October 15 through December 7

During the annual Medicare Advantage and Part D enrollment period, eligible Medicare beneficiaries may make certain coverage changes for the following year. Changes generally take effect January 1.

January 1 through March 31

The Medicare Advantage Open Enrollment Period is for people already enrolled in Medicare Advantage. The changes permitted are narrower than the fall annual period. Confirm current rules before acting.

Special Enrollment Periods can apply after certain events or changes. Eligibility and timing depend on the circumstances; use current Medicare guidance rather than assuming a special right applies.

Protect private information

Prepare details without sending them through a public form

You may need prescription, provider, plan, cost, and personal information for an individual review. Do not submit Medicare numbers, Social Security numbers, medical history, prescription lists, provider lists, banking information, or plan credentials through a public contact form or ordinary email.

Official sources

Verify current information

Official sources reviewed July 21, 2026. Reverify dates, permitted changes, plan details, provider access rules, prescription coverage lists, costs, and availability before publication and each annual review season.

Continue your annual review

Use the checklist to organize current documents and the questions you want answered.

Contact and enrollment notice: Contacting Southern Shield does not enroll you in a Medicare plan, create coverage, or establish a Scope of Appointment. Additional required steps may apply before specific plan discussions. Do not send Medicare numbers, medical information, prescription details, financial information, or account information through public forms or ordinary email.