The Annual Enrollment Period runs from October 15 to December 7, and almost everyone treats it as an eight-week window in which to make a decision. In practice it is a twenty-minute decision surrounded by eight weeks of everybody trying to make it at once.
The work that determines whether the decision is any good happens in September, and almost all of it is paperwork.
Watch for one specific envelope
Your Medicare Advantage or Part D plan has to send you an Annual Notice of Change by September 30. It is thin, grey, dull, and looks exactly like the marketing it arrives alongside. It is also the single most important document your plan sends all year.
It tells you what changes on January 1: the premium, the deductible, the copays, the drug tiers, the network and the out-of-pocket maximum. There are six things worth checking in it, and it takes about ten minutes.
Put it somewhere you will find it in October. Every year we speak to people who threw it out with the flyers.
Build the list that makes a comparison possible
A plan comparison is only as good as the information behind it, and the information nearly always missing is the drug list.
- Every prescription, with the dose and how often you take it. Not the brand you think you take — what the label says
- The pharmacy you use, by name and location. Preferred and standard pharmacies inside the same plan can produce very different annual totals
- The doctors and the hospital you want to keep
- Anything already scheduled for next year — a surgery, a course of therapy, a new specialist
Dose is not a detail
The same drug at two different strengths can sit on two different formulary tiers, carry different quantity limits, or require prior authorization at one strength and not the other.
This is why we ask people to bring the actual bottles rather than a list written from memory. The bottles carry the dose, the quantity and the prescriber, and they take thirty seconds to photograph.
October 1 is when the noise starts
Plans may begin marketing next year’s coverage from October 1, even though nobody can enroll until October 15. Expect mail, expect television, and expect at least one envelope designed to look like it came from the government.
None of it is a comparison. A mailer is an advertisement for one carrier’s plans, and a television advertisement is an advertisement for whichever plans the advertiser is contracted to sell. That is not a criticism — it is simply what those things are.
The useful question to ask anyone who contacts you is how many carriers they represent in your county, and whether they will show you the ones that pay them least.
Decide what you are actually testing
Most people go into AEP asking whether they can lower their premium. It is the wrong first question. Three better ones:
- Is my drug coverage still right? Formularies change every January, and a drug that was tier two can become tier four without your prescription changing at all
- Is my network still right? Doctors and hospitals join and leave plans annually
- Is my worst case still acceptable? On an Advantage plan the worst case is the out-of-pocket maximum, and it can move by a meaningful amount year to year
Premium matters, but it is the fourth question, not the first. The Part D total cost estimator shows why: two plans separated by a few dollars of monthly premium routinely finish the year hundreds apart in the other direction.
If you have a supplement, September looks different
Medigap is not part of AEP. There is no annual re-shopping window with guaranteed acceptance, and switching supplements outside a guaranteed-issue situation generally means medical underwriting. Your September job is therefore the Part D plan, which does reset annually and deserves the same review as anyone else’s.
It is still worth knowing what your supplement premium has done over the past three years, because that trend is the real cost of the policy. That is a conversation to have deliberately, not one to start in the middle of AEP. More on the trade-off in Medicare Advantage vs Medigap.
A week-by-week September
| Week | What to do |
|---|---|
| Early September | Photograph your pill bottles. Write down your pharmacy and your doctors |
| Mid September | Note anything that changed this year — a new diagnosis, a new specialist, a move |
| Late September | Read the Annual Notice of Change as soon as it lands |
| End of September | Book your review. October and November fill up first |
Staying put is allowed
A review that ends with “your plan is still the right one” is a good review. It is not a wasted appointment — it is the only way to know the answer.
What is not fine is arriving at January 1 having never opened the envelope, and discovering the change at a pharmacy counter.
An annual coverage review costs nothing and takes about twenty minutes once your list is ready. If you would rather read the whole thing first, the complete AEP guide covers the mechanics in detail — or book the call now and hold a slot before the rush.
Frequently asked questions
Can I change my Medicare plan in September?
Generally no. The Annual Enrollment Period does not open until October 15, and outside it you need a Special Enrollment Period — triggered by something like a move, a loss of employer coverage, or qualifying for Extra Help. September is preparation time, not enrollment time.
What is the Annual Notice of Change and when does it arrive?
It is the document your Medicare Advantage or Part D plan must send each year setting out what changes on January 1 — premium, deductible, copays, drug tiers and network. Plans are required to get it to you by September 30.
Do I have to do anything during AEP if I am happy with my plan?
You do not have to change anything, but you should still check. Formularies, tiers, networks and out-of-pocket maximums all reset on January 1, so the plan you are happy with in December may be a different plan in January. Staying put is a fine outcome when it is a decision rather than a default.