Medicare Advantage Open Enrollment: A Second Chance to Make a Change
- Feb 11
- 2 min read
If you are enrolled in a Medicare Advantage plan and find that it is not working as well as you hoped, there is a special window each year that gives you a chance to make one change. The Medicare Advantage Open Enrollment Period runs from Jan. 1 through March 31.
This enrollment period is different from the fall Medicare Open Enrollment Period that runs from Oct. 15 to Dec. 7. It is only for people who are already enrolled in an MA plan. If you have Original Medicare and want to join an MA plan for the first time, you generally must wait until the fall.
What changes you can make
During the Medicare Advantage Open Enrollment Period, you can make one of the following changes:
Switch from your current Medicare Advantage plan to another Medicare Advantage plan, with or without prescription drug coverage.
Drop your Medicare Advantage plan and return to Original Medicare, with the option to enroll in a separate Part D prescription drug plan.
You are allowed to make only one change during this period. Once that change is made, you must wait until the next enrollment period to make another change unless you qualify for a Special Enrollment Period.
Any change you make takes effect on the first day of the following month.
Why people use this enrollment period
Higher costs than expected. You may find that copays, deductibles or out-of-pocket costs are higher than you anticipated based on your actual health care use.
Doctor or hospital network issues. Some people learn after enrolling that their doctor, specialist or preferred hospital is not in the plan's network.
Prescription drug coverage problems. A plan's drug formulary may not include a medication you need, or it may place it in a higher-cost tier.
Dissatisfaction with care rules. Prior authorization requirements or delays in approvals can be frustrating for some enrollees.
Fewer plan or provider options. In some areas, health systems and providers have reduced their participation in Medicare Advantage plans.
What to know before switching back to Original Medicare
If you decide to leave Medicare Advantage and return to Original Medicare, it is important to think about supplemental coverage. Original Medicare does not have an annual out-of-pocket limit, so many people consider a Medigap policy, which will often cover deductibles and coinsurance that you would normally have to pay out of pocket.
However, if you don't enroll in a Medigap (also known as Medicare Supplement) policy when you are first eligible for Medicare, you can be denied for any reason and/or face higher premiums. Before dropping your MA plan, check whether a Medigap policy is available to you and at what cost.
The bottom line
If costs, provider access or drug coverage are not what you expected, this Jan. 1 to March 31 window may be your best chance to adjust your coverage for the rest of the year.
Give us a call at 951-297-9052. We can look at the options available to you in your area and see if another plan would better fit your needs.
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