Between October 15th and December 7th, you have the ability to review your Medicare coverage and make changes for the year ahead. But an open window doesn't automatically mean you need to walk through it. Sometimes the right answer is to stay exactly where you are.
Either way, that decision deserves more than a guess. Here are five questions I'd encourage you to sit with before you enroll in anything this year, whether that means staying put or making a change.
1. Am I Happy With My Current Plan?
Start here, honestly. Not "is it fine," but genuinely: has this plan served you well this year? Have you gotten the care you needed, when you needed it, without unnecessary friction?
It's easy to let a plan carry over out of habit rather than genuine satisfaction. This question is your chance to separate the two.
2. Do the Costs Feel Too High?
Costs can shift year to year, sometimes without you noticing until you add it all up. Premiums, deductibles, copays, coinsurance, prescription costs, they're all worth a second look.
I'm not asking whether you'd like to pay less. Most people would. I'm asking whether what you're currently paying feels proportionate to the coverage and care you're actually getting. That's a different, more useful question.
3. How Have My Customer Service Experiences Been?
This one gets overlooked constantly, and I think that's a mistake. When you've needed to call about a claim, a referral, a billing question, or anything else, how did that go? Were you able to get answers? Did you feel like a number, or did you feel like someone actually helped you?
Coverage on paper and coverage in practice aren't always the same thing. Customer service is where that gap tends to show up first.
4. Are My Doctors Covered?
This is the question I'd put at the very top of most people's list, because I've watched what happens when it gets skipped. Networks change. A plan that included your cardiologist or your primary care provider last year isn't guaranteed to include them this year.
Before you assume anything is staying the same, actually confirm it. Pull up your specific doctors and specialists and check them against the plan you're on or considering. Don't rely on memory or last year's paperwork.
5. Where Are the Holes or Blind Spots in My Current Coverage?
This is the hardest question to answer alone, because blind spots are, by definition, things you're not seeing. That's not a knock on you. It's just how blind spots work.
This is often where a second set of eyes helps most, someone who knows what to look for and can walk through your specific situation with you rather than asking you to spot the gaps yourself.
Why I Think These Five Matter Most
In 20 years of nursing, I watched people get caught off guard by things they didn't know to ask about. Not because they weren't careful, but because nobody had walked them through the right questions at the right time.
That's really the purpose of this list. These aren't questions with a universal right answer, and answering them honestly doesn't mean you have to change anything. Plenty of people go through this exercise and confirm their current plan is still the right one. That's a perfectly good outcome. The goal isn't change for its own sake. It's making sure whatever you decide, you decided it with clear eyes.
Let's Go Through Them Together
If you'd rather talk through these five questions with someone than sit with them alone, I'm glad to help. We can go through your specific plan, your doctors, and your costs together, and you can walk away with clarity either way.
You can book a time HERE.
Government Required Disclaimer: Roger Walters is not affiliated with the U.S. Federal Government or the Federal Medicare program. Agents may not offer every plan available in your area. Any information provided is limited to those plans agents do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
