The calendar says November, which means two things: the holidays are approaching, and the clock is ticking on your Medicare plan. Every year, your Medicare Advantage or Part D plan can change its costs, covered drugs, and even its doctor network. Ignoring the mail from your current carrier means you could automatically roll into a 2026 plan that costs you thousands more or forces you to switch doctors. Since the Annual Enrollment Period (AEP) ends on December 7th, now is the time to ask the hard questions. As your independent insurance guide, we’ve broken down the 5 most critical checks you need to make right now, along with an important new rule from CMS that could affect your care.
The 5 Essential Questions for AEP
Your Annual Notice of Change (ANOC) arrived for a reason. Don’t throw it out! Here are the five non-negotiable questions you need to answer before the December 7th deadline:
- Is my Doctor Still In-Network?
- The Change to Watch: Networks change every year. Your favorite specialist or primary care doctor might no longer be “in-network” on January 1st. Action: Check the plan’s updated provider directory now. If you need help verifying your doctor’s status across new plans, that’s what we do.
- Are My Prescriptions Still Covered (and How Much Will They Cost)?
- The Change to Watch: Even if your drug is covered, the cost tier may have moved, increasing your co-pay. Also, check to see if your plan is substituting a generic. Action: Use the plan’s updated formulary. Remember that out-of-pocket prescription costs are capped at $2,100 in 2026, but you want a plan that gets you below that number faster.
- Are My Other Benefits Shrinking?
- The Change to Watch: Many Advantage plans offer vision, dental, or gym memberships. Check if the value of these Supplemental Benefits for the Chronically Ill (SSBCI) is being reduced or if they’ve changed what they cover.
- How High is the Out-of-Pocket Max (and Deductibles)?
- The Change to Watch: Even if your premium is low, your maximum out-of-pocket costs could be rising. Compare your plan’s Part B premium increase (which is set to rise in 2026) against any lower premiums in a new Advantage plan.
- Am I Protected From Surprise Prior Authorizations?
- The Change to Watch: CMS has been working to limit the misuse of prior authorization, requiring plans to honor medical necessity decisions and be more transparent about their approval rules. You need a plan that doesn’t put up unnecessary roadblocks to the care you need.
The New Rule to Watch (Compliance & Trust)
CMS continues to tighten regulations to protect beneficiaries from confusing or misleading marketing. For 2026, regulators have significantly expanded the definition of “marketing” to cover even more materials.
What This Means for You: It means there is greater oversight on insurance carriers and agents than ever before, with the goal of ensuring marketing is equitable and non-discriminatory. If you encounter pressure, pushy sales tactics, or plans that sound too good to be true, they likely are.
The Basey Difference: As an independent and compliance-focused guide, our promise is to simplify, never to mislead. We focus only on what is right for your health, your doctors, and your budget.
Conclusion
The deadline is December 7th. Don’t risk starting 2026 with the wrong coverage.
Take the guesswork out of the AEP and let Basey Insurance review your plan changes for free. We’ll analyze your options across every major carrier to make sure you have the right insurance coverage for your needs.
Schedule your free, no-pressure consultation today!
