If your car insurance premium went up and you never checked the market, you would probably feel pretty foolish. The same logic applies to Medicare — and every year, starting October 15, you get a fresh window to do something about it.
What Is the Medicare Annual Enrollment Period?
The Medicare Annual Enrollment Period — commonly called AEP — runs from October 15 through December 7 every year. It is the one time when all Medicare beneficiaries have a guaranteed, no-questions-asked opportunity to change their coverage for the coming year.
If you are currently enrolled in a Medicare Advantage plan or a Medicare Part D prescription drug plan, this is your annual window to reassess. Even if you are on Original Medicare with a Supplement plan, the period matters for Part D decisions and for checking whether your coverage still fits.
Brian Barrett, a licensed Medicare insurance advisor in Cape Coral with 25 years of experience in education before becoming an insurance advisor, has guided hundreds of Lee County residents through this process. “Most people set their plan and forget it,” he says. “But plans change every year — and so do your health needs.”
Here are five reasons to take this window seriously.
1. Your Plan’s Premium, Deductible, and Out-of-Pocket Costs Can Change Every Year
This is the most straightforward reason to review your coverage annually. Medicare Advantage plans and Part D prescription drug plans file their changes with CMS each year, and those changes take effect on January 1.
What might be different next year?
- Your monthly premium may increase — or decrease
- Your prescription drug deductible may reset
- Your out-of-pocket maximum (the most you pay before plan coverage kicks in fully) can change
- Your coinsurance and copay amounts for specific services may be adjusted
These may sound like small numbers individually, but taken together, they can add hundreds of dollars to your annual healthcare spending. A Medicare Advantage plan in Southwest Florida that looked good in January 2025 may no longer be the most cost-effective option for your situation in 2026.
During AEP, you can compare the actual cost structures of every available plan in Lee County — not just the one you currently hold. That comparison is the only way to know whether you are paying more than you need to.
2. Your Doctors and Medications May No Longer Be Covered the Same Way
Medicare Advantage plans in Florida operate with defined provider networks. These networks can change from one plan year to the next — a specialist you see regularly might leave the network, or a hospital in your area might no longer be in-network for your specific plan.
The same applies to prescription drug coverage. Each Medicare Part D plan has a formulary — a list of covered drugs — that is updated annually. A medication you take regularly might move to a higher cost tier, or it might be removed from your plan’s formulary entirely and replaced with a different covered alternative. These changes are not optional or negotiable; they are the plan’s terms for the coming year.
If you had surgery, received a new diagnosis, or started seeing new specialists over the past year, your network coverage may no longer be the right fit. A Medicare Advantage plan that covered your doctors well in 2025 may not do so in 2026 — unless you make a change during AEP.
Before the December 7 deadline, confirm that your current plan still covers your pharmacy, your prescriptions, and the providers you actually use.
3. New Plans Enter the Market and Old Ones Exit
Every year, insurance carriers introduce new Medicare Advantage and Part D plans — and some plans are discontinued. A carrier that did not serve Lee County last year may now offer a plan in your zip code. A plan you have held for several years may have been discontinued or significantly restructured.
This is not hypothetical. In 2025 and 2026, multiple national carriers reduced their Medicare Advantage footprint in Florida counties, leaving some beneficiaries needing to find new coverage. If you missed a notification that your plan was exiting the market, you may be defaulting to a different plan structure — or finding yourself without the coverage you expected.
Reviewing what is available during AEP means you choose your plan with full information, rather than being assigned one by default.
4. Your Health Situation Has Probably Changed — Your Plan Should Reflect That
Medicare is used by people with evolving health needs. A plan that was appropriate two years ago may no longer fit your current situation.
Consider what might have changed over the past year:
- A new diagnosis that requires regular specialist visits or specific medications
- A planned surgery or procedure where you want to understand your hospital and rehab coverage
- Increased or decreased usage of prescription drugs that changes which Part D tier makes the most financial sense
- A change in your ability to manage out-of-pocket costs that makes a lower-premium/higher-deductible plan less attractive
Nobody knows your health situation better than you do. If your circumstances have shifted, that is a reason to sit down with an independent Medicare agent and look at your options honestly — not a reason to simply re-enroll in the same plan out of habit.
5. Medicare Advantage vs. Original Medicare + Supplement: Your Needs May Have Shifted
One of the most important decisions in Medicare is choosing between Medicare Advantage vs. Original Medicare with a Supplement. This decision deserves revisiting every few years, and AEP is the right time to do it.
Medicare Advantage plans bundle your hospital, medical, and often drug coverage into a single plan — sometimes with additional benefits like dental, vision, and hearing. They typically have lower monthly premiums than buying Supplement plans separately, but they come with prior authorization requirements, provider network restrictions, and yearly coverage limits.
Original Medicare plus a Supplement (Medigap) plan gives you broader access to any provider that accepts Medicare — which is the vast majority of providers nationwide — without network restrictions or prior authorization for most services. However, you will need a separate Part D plan for prescription drugs, and the combined monthly premium is typically higher.
If you enrolled in Medicare Advantage during a previous AEP but have since grown frustrated with network limitations, or if you have been on Original Medicare and Supplement for years and wonder whether Advantage might now make sense, AEP gives you the chance to explore that switch with full information.
Frequently Asked Questions
When is the Medicare Annual Enrollment Period?
The AEP runs from October 15 through December 7 every year. Any changes you make during this window take effect on January 1 of the following year.
Do I have to change plans during AEP if I am happy with my current coverage?
No. If your current plan still meets your needs and the costs have not changed significantly, you are not required to make changes. However, reviewing your plan is always recommended — your health needs and the plan’s terms can shift year to year without notice.
What can I change during the Annual Enrollment Period?
You can switch from one Medicare Advantage plan to another, switch from Medicare Advantage back to Original Medicare, add or drop a Part D prescription drug plan, or change Part D plans. You cannot make Medigap enrollment changes during AEP — that is governed by different rules.
How do I know if my current plan is still the best option for me?
Comparing plans requires looking at your specific doctors, medications, and anticipated healthcare needs for the coming year — not just the premium. That is exactly what an independent Medicare agent does. Brian Barrett offers complimentary Medicare reviews in Cape Coral with no sales pressure.
Can I get help reviewing my Medicare options in Cape Coral?
Yes. Brian Barrett is a licensed independent Medicare agent in Cape Coral, serving Lee County and Southwest Florida. He works with multiple carriers and can show you the full picture — not just one company’s options.
Talk to Brian Barrett, Cape Coral’s Medicare Advisor
If any of the five reasons above resonated with you, this is the right time to act. The Annual Enrollment Period closes December 7 — and planning ahead means you have time to make a thoughtful decision, not a rushed one.
Brian Barrett offers a free, no-pressure Medicare review for residents of Cape Coral, Fort Myers, and Lee County. He will go through your current coverage, explain what has changed, and show you what other options look like — without pitching a single plan until you have the full picture.
Get a free Medicare review — call 239-980-8599 or visit srhealthinsurancepros.com.
Brian Barrett is a licensed independent Medicare insurance advisor serving Cape Coral and Lee County, Florida. License #W483785.
We are not connected with or endorsed by the U.S. Government or the federal Medicare program. We do not offer every plan available in your area. Currently we represent [X] organizations which offer [Y] products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options.
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