New Year, New Health Plan

Happy 2026! Now that the new plan year has officially begun, many beneficiaries are looking for ways to stay healthy and proactive. Whether you are in a new plan or stayed with your current coverage, January is the best time to review the "fine print" and ensure you aren't leaving valuable services on the table.

Because every plan is unique, the key to maximizing your coverage is knowing where to look. Here is your roadmap for a healthy 2026.

1. Review Your "Evidence of Coverage" (EOC)

The most important document you have is your Evidence of Coverage. This is a detailed guide that explains exactly what your plan covers, how much you pay, and how to access your benefits.

• Tip: If you haven’t received a physical copy, you can usually download a digital version from your plan’s member portal.

2. Utilize Your Annual Wellness Visit

A core feature of Medicare is the Annual Wellness Visit. This is not a typical physical; rather, it is a scheduled time for you and your healthcare provider to develop or update a personalized prevention plan.

• The Goal: To prevent disease and disability based on your current health and risk factors.

• The Cost: For most beneficiaries, this visit is covered with $0 out-of-pocket cost when using an in-network provider.

3. Identify Your Supplemental Benefits

Many 2026 plans offer "supplemental benefits"—additional health services that go beyond what is traditionally covered by Original Medicare. These are often designed to support your overall well-being.

• How to find them: Look in your Summary of Benefits or Evidence of Coverage under the "Extra Benefits" or "Supplemental Benefits" sections.

• What to check: Look for allowances or credits for health-related supplies and services. Many of these operate on a "use it or lose it" basis each quarter, so it is important to understand your plan's specific rules today.

4. Verify Your Preferred Providers and Pharmacies

Even if you kept the same plan, networks can change. Before your first appointment of the year, it is a wise practice to:

• Confirm Network Status: Check the plan's online provider directory to ensure your doctors are still listed as in-network.

• Check Pharmacy Tiers: Costs for prescriptions can vary depending on which pharmacy you use. Confirm which local pharmacies are considered "preferred" for your specific 2026 plan.

Personalized Support for Your Unique Journey

Medicare guidelines are precise, and a benefit that works for your neighbor might not be available in your specific plan or area. Every circumstance is different, and there is no substitute for personalized, factual information.

If you have questions about how to access your 2026 benefits or want to confirm your coverage details, contact me today. As your local licensed insurance agent, I can provide the neutral, educational support you need to make the most of your health plan all year long.