Quick Summary:
The Medicare Annual Enrollment Period (AEP) is open from October 15 through December 7. This is your yearly window to make eligible changes to your Medicare health and drug coverage, with new coverage generally beginning January 1 when your enrollment request is received by December 7. A quick annual review can help make sure your plan still fits your doctors, prescriptions, budget, and health needs.
For many Medicare beneficiaries in Jourdanton, TX, the fall mail brings an important document: the Annual Notice of Change. It can be tempting to set it aside, especially when your current coverage has worked well. But Medicare plans can change from year to year—and a plan that was a great fit last year may not be the best choice for the year ahead.
At Affinity Insurance Services, Donna Valdez and Jessica Sanchez help clients throughout Jourdanton, Atascosa County, and surrounding Texas communities complete a thoughtful Medicare annual plan review. We make the process personal, clear, and comfortable—en español también. Here are five important items to check before December 7.
1. Are Your Doctors Still In-Network?
Your relationship with your doctors matters. If you have a Medicare Advantage
plan, provider networks can change from one year to the next. A physician, specialist, hospital, or clinic that was in-network this year may not be in-network next year, or the plan may have different rules for referrals and out-of-network care.
Before deciding to keep your current plan, make a list of the providers you see regularly. Include your primary care physician, specialists, preferred hospital, and any doctors you may need for an ongoing condition. Then verify that each provider participates in the plan you are considering for the coming year.
This is one of the most important parts of a Medicare plan comparison. Affinity Insurance Services can help you review provider access so you understand how your coverage may work before January arrives.
2. Are Your Medications Still on the Formulary?
Prescription drug coverage deserves a close look every AEP. Plans may change their formularies, which are lists of covered medications. A drug you take today could move to a different coverage tier, require prior authorization, have quantity limits, or no longer be covered by the same plan next year.
Bring an updated list of every prescription medication you take, including the dosage and how often you take it. This allows Donna and Jessica to compare how your medications may be covered under available options. If you have Original Medicare, your Medicare Part D
prescription drug plan is especially important to review. If you have a Medicare Advantage plan with drug coverage, we can look at the health and prescription benefits together.
A plan with a low premium may not be the lowest-cost choice if it makes your medications more expensive. Looking at the full picture can help you avoid surprises at the pharmacy.
3. Did Your Premium or Out-of-Pocket Costs Change?
Premiums are only one part of your Medicare costs. Review your plan’s deductible, copays, coinsurance, maximum out-of-pocket amount, and prescription costs. Even a small change in a specialist copay or medication tier can add up over a year, particularly if you expect frequent appointments or ongoing treatment.
During your Medicare annual plan review, it is helpful to think about how you used care this year. Did you visit specialists more often than expected? Did you have a hospital stay, outpatient procedure, or physical therapy? Are you anticipating new care next year? Your answers can help guide a more meaningful comparison.
For clients considering Original Medicare, we can also explain how a Medicare Supplement
plan may help with certain out-of-pocket costs. Medicare Supplement coverage has separate enrollment rules, so it is important to discuss your situation before making changes.
4. Are There New Plan Options in Atascosa County?
Plan availability can vary by county. New Medicare Advantage plans may become available in Atascosa County, while existing plans may update their benefits, provider networks, service areas, or drug coverage. That is why comparing only your current plan is not always enough.
When you compare Medicare Advantage plans, consider more than a television commercial or a headline benefit. Look at the doctors and facilities you prefer, your prescription coverage, monthly costs, copays, plan rules, and the plan’s overall fit for your daily life.
Affinity Insurance Services is a local Texas insurance agency that takes time to explain your options in plain language. Our goal is not to rush you into a decision. It is to help you understand the choices available to you and feel confident about the plan you select.
5. Are You Missing Benefits That Could Support Your Health?
Some Medicare Advantage plans may include extra benefits beyond standard medical coverage, such as dental, vision, hearing, fitness programs, transportation, or over-the-counter allowances. These benefits can be valuable, but they should be weighed alongside the coverage that matters most: access to care, prescriptions, and predictable costs.
If dental and vision needs are important to you, ask how the benefit works. Is there a network? Is there an annual allowance? What services are covered? Are there limits or waiting periods? A benefit is most helpful when it matches how you will realistically use it.
Our team can help you review these details as part of the larger picture. We believe Medicare enrollment help should feel personal—not confusing or one-size-fits-all.
Why an Annual Review Matters
Your health needs, doctors, medications, and financial priorities can change. Plans can change, too. Taking time during the Medicare Annual Enrollment Period to compare your options gives you the opportunity to make an informed decision before the December 7 deadline.
Whether you are already enrolled, reviewing a plan for a spouse, or preparing for Medicare as you approach age 65, Affinity Insurance Services is here to help. Start with our Medicare overview, then schedule time with Donna Valdez or Jessica Sanchez for a one-on-one review in Jourdanton or by phone.
FAQ
When is the Medicare Annual Enrollment Period?
The Medicare Annual Enrollment Period runs from October 15 through December 7 each year. Changes made during this period generally take effect January 1, provided the plan receives your request by December 7.
Do I have to change my Medicare plan every year?
No. You do not have to change plans, but reviewing your coverage annually is wise because costs, provider networks, drug formularies, and benefits may change.
Can I switch from Original Medicare to Medicare Advantage during AEP?
In many cases, yes. AEP allows eligible Medicare beneficiaries to make changes to Medicare health and drug coverage. We can help you understand the options and considerations for your situation.
Can Affinity Insurance Services help me in Spanish?
Yes. Donna Valdez and Jessica Sanchez are proud to offer bilingual support for clients who prefer to review Medicare options en español.
How do I schedule a Medicare review?
Contact Affinity Insurance Services to schedule your Medicare annual plan review. We are proud to serve Jourdanton, Atascosa County, and nearby communities with trusted local guidance. Let’s review your options together before December 7.