How to Prepare for AEP: Medicare Coverage Basics

AEP at a glance

The Medicare Annual Enrollment Period runs from October 15–December 7.
Changes take effect January 1 of the next year.

During AEP, you can:

• Switch Medicare Advantage plans.
• Change or enroll in a Part D drug plan.
• Move between Original Medicare + Medigap + Part D and Medicare Advantage.

The four parts of Medicare (quick refresher)

Part A — Hospital insurance

Part A covers inpatient hospital stays, skilled nursing facilities, hospice, and some home health care.
Most people pay no premium if they worked enough quarters.

Part B — Medical insurance

Part B covers doctor visits, preventive care, outpatient services, lab work, imaging, and durable medical equipment.
You pay a monthly premium and potential coinsurance.

Part C — Medicare Advantage

Private plans that replace Original Medicare with a bundled option.
Most include A and B, and many include Part D. Plans can add extras like dental, vision, or hearing.

Part D — Prescription drug coverage

Private plans that cover prescriptions.
You choose a plan based on your medications and pharmacy preferences.

Medigap vs. Medicare Advantage: which path fits?

Choosing a path first makes AEP easier. Start with how you prefer care and costs.

Consider Medigap if you want:

• Freedom to see any provider that accepts Medicare.
• Predictable out-of-pocket costs.
• No network referrals.

Consider Medicare Advantage if you want:

• One card for medical and drug benefits.
• Often lower premiums but pay-as-you-go copays.
• Extra benefits like dental or vision, with network rules.

Drug coverage reminder:

• Medigap users usually pair a stand-alone Part D.
• Many Medicare Advantage plans already include Part D.

What to review before AEP (your checklist)

Use this list to prepare. You’ll compare faster and avoid surprises.

1. Doctors and hospitals
   1. Are your providers in a plan’s network?
   2. Any referral rules or prior authorization?
2. Prescriptions
   1. Check each medication in the plan’s formulary.
   2. Review tiers, prior auth, and pharmacy pricing.
3. Total cost picture
   1. Monthly premium, copays, and coinsurance.
   2. MOOP (Maximum Out-of-Pocket) on Medicare Advantage.
   3. Part B premium and any IRMAA if applicable.
4. Coverage changes for next year
   1. Read your ANOC (Annual Notice of Change).
   2. Note changes to drugs, networks, or benefits.
5. Travel and snowbird needs
   1. Out-of-area coverage and network access.
   2. Emergency and urgent care rules.
6. Chronic care and specialists
   1. Prior auth, care management, and referral pathways.
   2. Access to centers of excellence if needed.

Timing and deadlines you should know

• AEP: Oct 15–Dec 7. Changes start Jan 1.
• MA OEP (Medicare Advantage Open Enrollment): Jan 1–Mar 31. One plan change allowed if you are in an MA plan.
• Special Enrollment Periods: Possible after qualifying life events.

How Brickhouse helps during AEP

We keep this process simple and transparent.

• Plan strategy first: We start with Medigap vs. Medicare Advantage.
• Benefit/Drug/Doctor alignment: We check networks, drugs, and benefits for fit.
• Cost clarity: We compare premiums, copays, and estimated annual costs.
• Action plan: We outline your options and next steps in plain language.

FAQs

Do I need all four parts of Medicare?
Not always. Most people have A and B. You then choose Medigap + Part D or a Medicare Advantage plan that often includes drug coverage.

Can I change the parts I have during AEP?
Yes. AEP lets you switch Medicare Advantage and Part D plans. Changes start January 1.
Medigap changes may require underwriting outside your initial window.

What’s the difference between Medigap and Part C?
Medigap works with Original Medicare to reduce out-of-pocket costs. You add a separate Part D if needed.
Part C (Medicare Advantage) replaces Original Medicare with a private plan. Networks and copays vary by plan.

Does Brickhouse help with stand-alone Part D?
We don’t enroll clients in PDP-only plans. For PDP comparisons, use Medicare.gov for real-time pricing and coverage.

What documents should I gather before my review?
Make a list of your doctors, preferred hospitals, and current medications.
Have last year’s ANOC and your budget targets ready.

Final Thoughts

Original Medicare is a solid foundation — but it’s not a full house.

It’s important to know what it covers, where the gaps are, and how to fill them. That’s where working with a trusted Medicare insurance agent helps.

If you don’t already have one, Brickhouse Agency offers no-cost, no-obligation consultations to walk you through your options and help you build a plan that fits your life — not someone else’s.

Book your free Medicare consultation

About the Author
Niki Feret is the founder of Brickhouse Agency, a boutique Medicare insurance agency licensed in 37 states. As one of the few female agency owners in the industry, Niki leads with clarity, compassion, and a commitment to education — not pressure. Learn more or book your free Medicare consultation at BrickhouseAgency.com.