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Medicare Advantage Plan Benefits Change Yearly

Many Illinois seniors do not realize that coverage and benefits change yearly with Part C plans, or fail to review the Annual Notice of Change before Annual Enrollment.

Review Coverage

As a member of Part C, each fall, you should receive an Annual Notice of Change. This document includes information about changes to your plan that will take effect the following January. Changes to your premium, deductibles, copayments, prescription, and network providers. Your maximum out-of-pocket limit may be reduced. This is your opportunity to review your coverage and decide if your plan still meets your needs.

Benefit Changes

Small changes can have a significant impact on your coverage and benefits, how much you pay out-of-pocket, and where you can go to receive services. Review network changes that may affect the doctors and hospitals you use. Your plan’s medication formulary may cover fewer medications next year. It’s a good idea to review the list carefully to ensure the medications are on the list and still available, and the pharmacy you use. Look for changes in how much you will need to pay to continue receiving the prescriptions you use regularly. It’s also important to review network changes that may affect the doctors and hospitals you use for your medical care.

Different Plans

There are many different Part C plans, some with prescription benefits included, and some without. HMOs and PPOs are not required to offer prescription benefits. If you choose this type of plan that does not offer coverage, you may not join a separate Part D plan. Plans must send an Annual Notice of Change no later than September 30, a couple of weeks before the start of Open Enrollment. If you don’t receive it, contact your plan administrator or agent. Details on how to request the notice can be found on the back of your membership card. If you decide to keep your plan, you don’t need to do anything at all and you will automatically be re-enrolled in your plan for another year.


Most plans do include benefits for prescription drugs, but no two plans are alike. It makes sense to find the one that fits your prescription needs best. If you take specific medications, compare plans by looking at the drugs that are included on the formulary, and be sure to identify which tier or tiers they are assigned to, how much they cost, and what pharmacies are in the network.



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