Worksheet
Medicare Annual Review Checklist
Review whether your next Medicare plan pass should focus on routine renewal, prescriptions and pharmacies, providers and networks, out-of-pocket costs, Medigap access, or getting help before changing coverage.
Medicare review file
Build the annual plan-review map
Start with the coverage structure, then review the notice, prescriptions, providers, costs, travel fit, switching path, and Medigap access before changing or renewing coverage.
Current structure
What Medicare coverage do you have now?
Start with how coverage works today because Original Medicare, Medigap, and Medicare Advantage create different review risks.
Plan notice
Have you reviewed the Annual Notice of Change?
The Annual Notice of Change is where next-year premium, cost, coverage, and network changes usually show up.
Drugs and pharmacy
What changed with prescriptions or pharmacy fit?
Use the actual current medication list and pharmacy preference, not last year’s memory of what worked.
Care access
What changed with doctors, hospitals, or expected care?
Provider fit matters most for Medicare Advantage, but Original Medicare users should still confirm key doctors accept Medicare.
Cost exposure
What changed with next-year costs?
Look beyond the premium and include deductibles, copays, coinsurance, drug costs, and maximum exposure.
Service area
Do travel or second-home needs affect plan fit?
A plan can look fine locally and still be awkward for seasonal living, frequent travel, or care elsewhere.
Decision direction
Are you considering keeping, comparing, or switching?
Switching inside the same plan type is different from moving between Medicare Advantage and Original Medicare.
Medigap access
Could Medigap access matter if you switch?
Medigap has separate availability rules; Medicare Open Enrollment does not automatically reopen supplement access.
Medicare annual-review checkpoint board
Use this board to separate routine renewal from drug coverage, provider access, cost exposure, travel fit, switching structure, and Medigap access questions.
Open
Coverage structure
Original Medicare, Medigap, Medicare Advantage, or an unclear current setup.
Answer this section before relying on the Medicare annual review file.
Open
Plan notice
Annual Notice of Change, Evidence of Coverage, and next-year plan updates.
Answer this section before relying on the Medicare annual review file.
Open
Prescriptions
Drug list, dosage, tier, restriction, refill pattern, and preferred pharmacy.
Answer this section before relying on the Medicare annual review file.
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Providers
Doctors, hospitals, specialists, referrals, prior authorization, and care patterns.
Answer this section before relying on the Medicare annual review file.
Open
Costs
Premiums, deductibles, copays, coinsurance, drug costs, and max out-of-pocket exposure.
Answer this section before relying on the Medicare annual review file.
Open
Travel fit
Seasonal living, frequent travel, second homes, and out-of-area care needs.
Answer this section before relying on the Medicare annual review file.
Open
Switching path
Keep current coverage, compare similar plans, or move between Medicare structures.
Answer this section before relying on the Medicare annual review file.
Open
Medigap access
Current supplement policy, underwriting, guaranteed issue rights, and state-specific rules.
Answer this section before relying on the Medicare annual review file.
- 1Answer current structure next.
- 2Use the Annual Notice of Change, drug list, pharmacy preference, provider list, and plan documents rather than memory alone.
- 3Pause plan changes until the review file points to a clear renewal, drug, provider, cost, Medigap, or help lane.
How to use this Medicare check
Use this review before keeping, comparing, switching, or dropping Medicare coverage. The goal is not a perfect score; it is a clearer plan-review agenda.
1
Start with the notice
Use the Annual Notice of Change, plan documents, current drug list, pharmacy preference, and provider list instead of last year’s memory.
2
Separate the review lanes
The checklist sorts renewal, drugs, providers, cost exposure, Medigap access, and plan-specific help into a practical next-review lane.
3
Confirm before switching
Use Medicare, SHIP, the plan, or a qualified professional before dropping, replacing, or changing coverage.
About this tool
What this helps you do
This review file organizes the annual Medicare pass before you keep a plan, compare similar plans, or consider changing coverage type.
Why annual review matters
Plans, formularies, pharmacies, provider networks, premiums, cost sharing, and service areas can change from one year to the next.
How to interpret results
A lower score does not mean the current plan is wrong. It means one review lane needs more facts before renewal feels clean.
Limitations
This tool is educational only. It does not compare live Medicare plans, determine Medigap eligibility, calculate penalties, or replace Medicare, SHIP, plan, tax, legal, or professional advice.
Keep learning
Medicare annual review can involve plan-specific formularies, pharmacy contracts, provider networks, service areas, Medigap availability, underwriting, guaranteed issue rights, income-related premiums, and state rules. Confirm those details with Medicare, SHIP, the plan, or qualified professionals before changing or dropping coverage.