Why an Annual Benefits Review Matters

Federal and state benefit programs are not static. Medicare plans update their formularies, premiums, and provider networks every January 1. Eligibility thresholds for income-based programs such as Medicaid, the Low-Income Subsidy (known as Extra Help), and Medicare Savings Programs are adjusted periodically. Life changes — a shift in income, a new prescription, a move to a different state — can open or close doors to assistance you may not know you qualify for.

Working through this checklist once a year, ideally between October and December, positions you to make informed decisions during the Medicare Annual Enrollment Period (October 15 – December 7) and before most state-program renewal deadlines. For a broader overview of programs covered below, see the Federal and State Benefits Programs reference guide.

Required

Medicare Plan Finder (medicare.gov)

Compare Medicare Advantage and Part D plans side-by-side using your current drugs and preferred pharmacies.

Required

My Social Security Account (ssa.gov)

Access your benefit statement, verify earnings history, and review any Medicare premium withholding.

Optional

BenefitsCheckUp (ncoa.org)

Screen for federal and state benefit programs you may be eligible for but not yet enrolled in.

Optional

State SHIP Contact Directory (shiphelp.org)

Locate a free State Health Insurance Assistance Program counselor for unbiased Medicare guidance.

Optional

Benefits.gov

Search federally administered assistance programs and check eligibility criteria in one place.

How to Use This Checklist

Work through each group in order. Mark items complete only after you have confirmed the detail — not merely recalled it. Some items require documents or account logins; gather those first using the tools section above. Items marked must are non-negotiable for maintaining uninterrupted coverage. Items marked should are strongly recommended and often lead to meaningful savings. Nice-to-have items round out your review and may uncover additional assistance.

Late Enrollment Penalties Are Permanent

Medicare Part B and Part D late-enrollment penalties do not expire — they are added to your monthly premium for as long as you are enrolled. If you delayed enrollment without qualifying creditable coverage, contact SSA promptly to understand your penalty status. Missing the Medicare Annual Enrollment Period can lock you into an unsuitable plan for a full calendar year, so confirming your enrollment window is a non-negotiable step.

Common enrollment mistakes — including missed deadlines and unreported income changes — are detailed in our guide to benefits enrollment gaps and errors. Review it alongside this checklist if you have had any coverage disruptions in the past year.

Document Preparation

Locate your current Medicare card, Summary of Benefits, and any Evidence of Coverage documents from your plan. Must
Gather your most recent Social Security benefit statement or award letter. Must
Collect your prior year's tax return or income documentation (W-2s, 1099s, pension statements) to verify income figures used for eligibility checks. Must
Note any life changes since last year: address change, marital status, new diagnosis, or significant income shift. Must

Medicare Coverage Review

Compare your current plan's Annual Notice of Change against your actual prescriptions and preferred providers to spot coverage differences. Must
Confirm that your primary care physician and any specialists you see regularly remain in-network for the coming plan year. Must
Check whether all current prescriptions are still on your plan's formulary and at the same tier level. Must
Review your Part B premium, Part D premium, and any plan-level copays or deductibles for the upcoming year. Should
Consider whether Medicare Advantage or Original Medicare still fits your health utilization patterns, especially if your care needs have changed. Should

Income-Based Assistance Eligibility

Check your current income and assets against the federal poverty guidelines to determine whether you may qualify for Extra Help (Low-Income Subsidy) to reduce Part D costs. Must
Review eligibility for a Medicare Savings Program (QMB, SLMB, QI) which can cover Part B premiums and cost-sharing; apply through your state Medicaid office if eligible. Must
Assess Medicaid eligibility if your income or assets have declined, using the Medicaid for Seniors eligibility guide as a reference. Should
Explore the full range of subsidy programs that may further reduce out-of-pocket Medicare costs. Nice to have

State and Federal Assistance Programs

Verify your SNAP (Supplemental Nutrition Assistance Program) eligibility or renewal status if you are currently enrolled or near income thresholds. Should
Check LIHEAP (Low Income Home Energy Assistance Program) availability in your state for heating and cooling cost assistance. Should
Inquire about state-specific pharmaceutical assistance programs, property tax relief, or transit subsidies available to seniors in your state. Nice to have
Use BenefitsCheckUp (ncoa.org) or Benefits.gov to screen for any additional federal or state programs you may not be enrolled in. Nice to have

Enrollment Window Verification

Confirm whether any upcoming enrollment period applies to you — Medicare AEP (Oct 15–Dec 7), Medicare Advantage OEP (Jan 1–Mar 31), or a Special Enrollment Period triggered by a qualifying life event. Must
Verify there are no late-enrollment penalties accumulating on Part B or Part D due to a prior coverage gap; contact SSA or Medicare.gov to clarify. Must
Check renewal deadlines for any state-administered programs (Medicaid, SNAP, LIHEAP) to avoid unintended termination. Must

After You Complete the Checklist

Once you have worked through every group, take three final steps. First, document what you confirmed or changed — a dated note or simple spreadsheet entry is sufficient. Second, set a calendar reminder for next October so the review becomes a reliable annual habit. Third, if any item raised questions you could not resolve on your own, contact your State Health Insurance Assistance Program (SHIP) for free, unbiased counseling; find your local SHIP through the eldercare.acl.gov locator.

For a complementary financial picture, consider pairing this checklist with the Retirement Income Readiness checklist, which covers income sources, account rules, and tax considerations. And if your review reveals health-screening gaps alongside benefits gaps, the Annual Health Checks guide outlines screenings generally recommended for adults over 65.

This article is for general informational and educational purposes only and does not constitute personalized financial, legal, or insurance advice. Program rules, income thresholds, and enrollment deadlines change frequently. Consult a licensed benefits counselor, financial adviser, or attorney for guidance specific to your circumstances.

Income Changes Must Be Reported Promptly

Failing to report a significant income increase or decrease to your state Medicaid office or the Social Security Administration can result in overpayments you will be required to repay, or in loss of benefits you are entitled to. Report changes as soon as they occur — do not wait for your annual review.