Your Medicare AEP prep guide
Every fall, Medicare gives you a chance to take a fresh look at your health coverage. This happens during the Annual Enrollment Period (AEP), October 15 through December 7. Any choices you make kick in on January 1 of the new year.
Think of AEP as your yearly check-up for coverage: Is your plan still working for you, or is it time for a change? To help you feel confident, here’s a simple guide with the top things to consider.
1. Mark your calendar
Medicare’s AEP, or open enrollment period, runs statewide in Virginia from October 15 through December 7. That’s your window to:
- Switch between Medicare Advantage and Original Medicare
- Change your Part D drug plan
- Pick a new Medicare Advantage plan
Tip: Even if you’re happy with your plan, it's a good idea to double-check that it still meets your needs for next year.
Special note for Dual Eligible Special Needs Plan (D-SNP) enrollees:
If you qualify for both Medicare and Medicaid, you may be eligible for a D-SNP, widely available across Virginia. These plans usually offer $0 premiums and comprehensive, integrated Medicare and Medicaid services. Unlike most Medicare Advantage plans, you don’t have to wait for AEP—you can join, switch, or drop a D-SNP once per month, all year long. Your D-SNP coverage and benefits typically begin the first day of the month after your enrollment is approved.
If your Medicaid status changes mid-year, you may get another chance to enroll in or switch D-SNP plans.
2. Review your plan’s changes
Each fall, your Medicare Advantage plan mails you an Annual Notice of Change (ANOC). This highlights what’s different in the upcoming year—things like:
- Premiums and copays
- Deductibles
- Coverage updates
- Provider network changes
Tip: Don’t toss this booklet in the trash. A quick review now can save you surprises later.
3. Double-check your doctors and prescriptions
Because your health needs change from year to year, take time to confirm:
- Your doctors and hospitals are still in-network
- Your prescriptions are covered, and at what cost
Tip: Make a list of your providers and medications before shopping around—it makes plan comparisons easier.
4. Don’t miss out on extra benefits
Many Medicare Advantage plans offer perks beyond medical care, like:
- Grocery and over-the-counter (OTC) allowances
- Dental, vision, and hearing coverage
- Fitness or wellness programs
- Transportation to appointments
5. Find out what’s new for 2026
AEP 2026 brings a wave of changes—higher costs, new protections, and extra benefits. Here are some of the biggest updates that could affect your coverage
- Part B premium increases: About $206.50/month in 2026 (an increase from 2025)
- Part D drug coverage changes:
- Base premium around $39/month
- Deductible capped at $615
- Out-of-pocket maximum set at $2,100
- Lower insulin costs: $35/month cap becomes permanent (no deductible)
- Vaccines at no cost: All recommended adult vaccines will be free under Part D
- Prescription payment plan: If you’re already enrolled, you’ll be automatically re-enrolled each year unless you opt out
- Medicare Advantage updates: Plans must now make prior authorizations easier and honor approvals through discharge from inpatient care
Tip: Rising costs make it especially important to shop around this year. The right plan could save you money in 2026.
Think of AEP as your yearly chance to “tune up” your coverage. By marking your calendar, reviewing your plan’s changes, checking your doctors and prescriptions, and knowing what’s new, you’ll head into the next year with confidence.
And if you qualify for a D-SNP in Virginia, you’ve got even more flexibility with monthly enrollment options all year long. D-SNP options are available almost statewide, often with no monthly premium and streamlined care coordination through “exclusively aligned enrollment.” That means one carrier handles both your Medicare and Medicaid, and you’ll use a single ID card.
A Sentara Medicare Dual Eligible Special Needs Plan (D-SNP) offers extra benefits designed to make life a little easier. These include personalized care coordination to help manage appointments and medications, as well as transportation to get you to and from medical visits.
To learn about a Sentara Medicare D-SNP, call a Licensed Plan Advisor at 1-877-550-3285 (TTY: 711) or visit sentaramedicare.com/DSNP.
October 1-March 31 | 7 days a week | 8 a.m.-8 p.m. or
April 1-September 30 | Monday-Friday | 8 a.m.-6 p.m.
Medicare AEP Q&A
Q: Do I have to change my plan during AEP?
A: No. If your current plan still works for you, you can stick with it. But a quick checkup ensures you’re not missing out.
Q: What happens if I ignore AEP?
A: You’ll stay in your current plan for 2026, unless your plan is ending.
Q: Can I switch from Original Medicare to Medicare Advantage?
A:Yes. AEP is the time to do that—or you can go back to Original Medicare from a Medicare Advantage plan.
Q: Can I change my Part D drug plan?
A: Absolutely. You can join, drop, or switch during AEP. Virginia residents can choose from multiple stand-alone Part D plans—at least 16 options statewide—with many offering lower premiums or even $0 plans.
Q: What if my plan is discontinued?
A: You’ll get a notice and may be automatically enrolled in another plan. It’s smart to review your options and choose what works best for you.
Q: What if I qualify for both Medicare and Medicaid?
A: If you’re eligible for both Medicare and Medicaid, you may be able to enroll in a Dual Eligible Special Needs Plan (D-SNP). You don’t have to wait for AEP. You can make changes once a month, all year long.
Q: What happens if my Medicaid coverage changes mid-year?
A: That usually opens a Special Enrollment Period to switch into or out of a D-SNP plan.
Q: How will my current plan change next year?
A: If you are a current Medicare Advantage plan beneficiary, you can check your Annual Notice of Change (ANOC) that lists updates in premiums, coverage, and provider networks.
Q: Are my doctors still in-network?
A: You should be able to check the plan’s website to see if your providers are in-network under current or new Medicare Advantage plans. Check out Sentara Medicare’s provider directory
Q: Will my plan cover all my medications?
A: You can view the drug formulary on the plan’s website to see if your prescription drugs are covered and if there are any special rules or restrictions. You can search Sentara Medicare’s prescriptions and pharmacies.
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Sources:
medicare.gov, cms.gov, cms.gov/newsroom, cms.gov/priorities/medicare-prescription-drug-affordability, medicareresources.org, federalregister.gov
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