Annual Medicare and ICHRA (CHOICE) Review

What do I need to review every year after my Medicare coverage begins?

Your coverage should continue to fit your doctors, prescriptions, budget, and ICHRA (CHOICE) contribution—not simply renew by default.

Quick answer

Review your Medicare coverage every year. Plans can change their providers, drug formularies, pharmacies, premiums, cost sharing, and benefits. Your employer can also change ICHRA (CHOICE) allowances or administrative details. The annual review makes sure the coverage you selected still works and that the employer contribution is connected to the right premiums.

Start with your current care

Make a list of the doctors, specialists, hospitals, services, and prescriptions you used this year. Then ask whether you expect any new care next year. This makes the review practical.

For Medicare Advantage, confirm that your doctors and facilities remain in network and that the plan’s referral or prior authorization rules still work for you. For Original Medicare with Medicare Supplement Insurance, confirm that your preferred providers still accept Medicare and review how your Part D plan handles your medications.

Review your prescription drug coverage every year

Part D and Medicare Advantage drug plans can change formularies, preferred pharmacies, drug tiers, deductibles, and coverage rules. A medication that worked well in the current year may cost more or require a different process next year. Bring the benefitbay Medicare Team an updated medication list, doses, and pharmacy preference before making a plan decision.

The annual review is also the time to look for a new prescription, a change from generic to brand, a new specialist, or a move that changes your available plan choices.

Review the total cost—not only the plan premium

Compare your Part B premium, any IRMAA notice, plan premium, deductible, copays, coinsurance, prescription costs, and maximum out-of-pocket exposure. Then look at the ICHRA (CHOICE) contribution and confirm how it will be applied in the new year.

A low premium does not always mean the lowest total cost. A plan with a broader network, better formulary fit, or more predictable cost sharing can be more valuable depending on how you use care.

Review the employer-benefit materials

Read every ICHRA (CHOICE) notice your employer sends. Confirm the new-year allowance, eligibility, premium payment process, and any action required under your employer plan. If your household changed—marriage, divorce, death, a new dependent, a spouse’s retirement, or a move—bring that information to HR and the benefitbay Medicare Team.

Know which plans can change when

Medicare Advantage and Part D plans have annual enrollment opportunities. Medicare Supplement Insurance does not operate the same way. Medicare Supplement Insurance changes can involve underwriting, state rules, and specific protections. Do not assume you can change every Medicare coverage type each fall using the same rules.

Make the annual review a routine