Key Takeaways

• Reviewing your previous year’s healthcare expenses helps you understand where most of your costs came from and which benefits matter most during this AEP.

• Using this information now can guide you toward a plan that better fits your expected medical needs and financial priorities for 2026.

Looking Back To Move Forward

Understanding your healthcare spending over the past year gives you a stronger foundation for making decisions during the Annual Enrollment Period (AEP). Since AEP runs from October 15 to December 7 each year, you have a limited time to review your needs and update your coverage for the upcoming year. When you take the time to look at your previous expenses, it becomes easier to identify what worked, what didn’t, and where you may need better protection or more predictable costs.

Why Last Year’s Spending Matters

Your expenses from the past 12 months tell a clear story about your healthcare usage. Even if your needs shift from year to year, there are usually patterns in how often you visit doctors, refill prescriptions, or receive routine services. Those patterns help you make informed decisions for 2026.

What Areas Should You Focus On First?

Start by looking at the basic categories of your care, including:

• Doctor visits

• Specialist appointments

• Outpatient services

• Emergency care

• Therapies or ongoing treatments

• Prescription drug needs

Once you know how often you used each type of service, you can compare these needs to your current plan’s benefits. This step helps you see if your plan provided the right balance of access and cost.

Identifying Repeat Costs

Some expenses repeat year after year, and these recurring costs often influence what type of plan may work better for you.

Which Costs Are Most Consistent?

You may find consistent patterns in:

• Prescription refills

• Follow-up care

• Chronic condition management

• Durable medical equipment needs

• Routine screenings

Plans vary in how they cover each of these areas. When you review last year’s spending, you create a clearer picture of what you expect next year. This comparison helps you determine whether your current plan still fits or whether a different option aligns better with your expected needs.

Tracking Changes In Your Health Needs

Your health might have changed since last AEP. Changes in your treatment plan, new prescriptions, or increased specialist visits may signal that your coverage no longer meets your needs.

What Should You Look At When Evaluating Changes?

Consider the following:

• Have your doctor visits become more frequent?

• Did you start a new medication this year?

• Are you scheduled for planned procedures in the next 12 months?

• Has your out-of-pocket spending increased unexpectedly?

These changes may influence what benefits you should prioritize for 2026. For example, frequent prescriptions may require stronger drug coverage, while ongoing therapy might call for lower copayments.

Comparing Costs Over The Year

You may notice that your expenses were not evenly spread throughout the year. Some months may have been more expensive due to follow-up care or medication adjustments.

Why Does This Matter For AEP?

Because uneven spending patterns help you understand:

• When you hit your deductible

• Whether your coinsurance was manageable

• If copayments were reasonable based on your visit frequency

• Whether your prescription drug spending increased across the three phases of Part D

This information helps you predict when similar costs might occur again in the next year and whether your current plan structure suits your budget.

Reviewing Prescription Drug Spending

Prescription medications often represent a large portion of annual healthcare expenses, making them one of the most important elements to review.

How Should You Assess Your Drug Costs?

Look at the following areas:

• Total yearly spending

• Frequency of refills

• Medications you stopped or added

• Any high-cost medications

• Whether you approached the out-of-pocket threshold

Knowing the details of your drug usage allows you to review your current plan’s drug formulary and pharmacy benefits to ensure they still provide effective coverage.

Estimating Your Health Spending For 2026

Once you analyze last year’s spending, you can estimate your likely expenses for 2026. While exact predictions are difficult, your previous year’s patterns give you a good baseline.

How Do You Make These Estimates?

Consider the following steps:

1. Identify routine medications you expect to continue.

2. Review any upcoming appointments or scheduled treatments.

3. Check whether your preferred doctors remain in-network.

4. Note whether your health conditions are stable or changing.

This predictive approach helps you create a realistic expectation of your future healthcare costs.

Choosing A Plan Based On Spending Patterns

Your spending review helps you decide what to prioritize during AEP. Different plans offer various combinations of cost-sharing, coverage levels, and provider access.

What Should You Prioritize When Selecting A Plan?

Think about:

• Lower coinsurance if you have regular outpatient visits

• Stronger prescription coverage if you take multiple medications

• Lower deductibles if you had high early-year expenses

• Broader networks if you use multiple specialists

• Predictable copayments for frequent services

Since AEP lasts from mid-October to early December, use this window to compare your options carefully, focusing on the benefits that matter most to your spending habits.

Checking Provider And Pharmacy Networks

Even if your spending review shows that your services are consistent, you still need to confirm that your doctors, specialists, and preferred pharmacies remain part of the plan’s network.

What Should You Verify About Networks?

Check:

• Whether your primary doctor is still in-network

• The status of specialists you visit

• Your preferred pharmacy’s network status

• Any network changes scheduled for 2026

Changes in networks can affect your costs significantly, so reviewing this information ensures continuity of care.

Preparing For Unexpected Healthcare Costs

Even with a detailed spending review, unexpected health needs can occur. You may want a plan that offers stronger protections or more predictable out-of-pocket limits.

How Can You Plan For Uncertainty?

Look at:

• Annual out-of-pocket maximums

• Emergency care coverage

• Coverage for sudden prescription changes

• Access to urgent care services

Selecting a plan with benefits that cushion unexpected costs helps you stay prepared throughout the coming year.

Bringing It All Together

Using last year’s healthcare expenses as a guide allows you to make more confident and informed decisions for AEP 2026. Your patterns reveal the benefits that matter most and highlight areas where your current plan may no longer be the best fit. When you understand your past needs, you give yourself a clearer path forward.

Use this opportunity to compare your options thoroughly and reach out to any of the licensed agents listed on this website if you want help reviewing your choices or understanding how your spending patterns may shape your plan selection for 2026.