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Medicare Advantage Open Enrollment: How to Change Plans, and Why

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If you started 2024 with a Medicare Advantage plan that you’re unhappy with, you’re stuck for the rest of the year – right? Wrong. Turns out you have until the end of March to make a change, which under the right circumstances might be a worthwhile option.

Contrary to popular assumption, Medicare actually has two open enrollment periods each year. Most people know about the open enrollment plan in the fall, running from mid-October through early December. But if you’re on a Medicare Advantage plan – like about half of all enrollees – there’s also an open enrollment period just for you, allowing the option to change plans, albeit with some limitations.

How should you evaluate your Medicare Advantage coverage to determine whether it makes sense to switch? That’s the subject of this recent NerdWallet article written by finance reporter Kate Ashford. While the experts she consulted don’t recommend changing plans lightly, they agree that there are reasons when a change makes sense. But you’ve only got a few more weeks to do your homework and make your selection. Let’s see what Ashford suggests.

Choosing a Medicare Advantage Plan Carelessly

Ashford writes, “Many people choose Medicare Advantage plans without exploring their options or noticing what changes their plan may have made, according to research from KFF, a health policy nonprofit.” There are plenty of reasons why this can happen, we would add – chief among them being the fact that the majority of seniors ignore open enrollment altogether.

For whatever reason, Ashford goes on, “now that a new year has started, you may realize the plan you picked during Medicare’s fall open enrollment doesn’t work for you. Or maybe you stuck with your old plan and it changed this year. (That can happen, too.)”

Medicare Advantage Open Enrollment Offers a Do-Over

If you’re already on a Medicare Advantage plan, then this open enrollment period was made for you. Medicare Advantage open enrollment began January 1st and ends March 31st. The purpose, NerdWallet explains, is to gives member the option to switch between Medicare Advantage plans, or to move back to original Medicare.

“It’s set up especially for people who begin the year enrolled in a Medicare Advantage plan and allows them to make certain changes,” says David Lipschutz, associate director of the Center for Medicare Advocacy.

According to Ashford’s article, here are the essential questions to ask.

Does Your Current MA Plan Still Meet Your Needs?

Ashford points out that many of us have never been forced to “try out” our Medicare Plans in a real-world situation of hospitalization, specialists, and tests. “Even if you haven’t had a chance to stress test your plan yet,” she emphasizes, “do some research while you still have time to change your mind.”

The two key questions involve providers and prescriptions, says NerdWallet.  Make sure the providers and specialists you want to see are in your network – and remember that this can change unexpectedly from year to year. “Also,” says Ashford, “check your medications, particularly if you’re on a newer drug that may be covered differently by different plans. How much do your prescriptions cost under your plan?”

Looking Into Your Health Care Crystal Ball

Ashford goes on to advise her readers to think ahead about their health situation in the remainder of the year. She spoke with Medicare insurance professional Christopher Fong from Mesa, Arizona, who urges people to do their best to male an educated guess about the health care they might need.

“Are there any procedures, like a surgery that’s coming up,” asks Fong?  “Is it outpatient? Inpatient? How many emergency room visits do you have? Do you need an electric scooter?” Ashford agrees. “The more you can predict your health care usage,” she states, “the more accurately you can determine whether you’re in the right plan.”

Your lifestyle considerations may have changed since you last reviewed your MA plan. “Do you travel or plan to spend part of the year in another state,” Ashford asks? “Make sure your insurance offers an extended network or travel benefit. Or consider Original Medicare, which allows you to see any doctor in the country who accepts Medicare.” (We’ll have a bit more to say on that in a moment.)

Choices During Medicare Advantage Open Enrollment

As noted above, Medicare Advantage open enrollment provides opportunities to change plans, but those choices are somewhat limited.

“During this time,” says Ashford, “people who are already enrolled in a Medicare Advantage plan can switch — once — to another Medicare Advantage plan, or they can return to Original Medicare and purchase a Medicare Part D prescription drug plan. But if you don’t already have Medicare Advantage, you can’t join a plan now.”

The article notes that policy holders have the option to leave Medicare Advantage and shift to original Medicare plus a Part D drug plan. But here’s an important restriction: you may not be able to sign up for Medicare Supplement Insurance, commonly called Medigap.

“Medigap’s open enrollment period — when insurance companies must offer you a plan at the same price as everyone else, regardless of health issues — lasts for six months after you’re 65 and have Medicare Part B,” Ashford explains. “After that, aside from a few states and situations, you’ll be subject to medical underwriting to qualify.”

“While you can get in and out of a Medicare Advantage plan on an annual basis, your rights to purchase a Medigap policy are usually far more restrictive,” David Lipschutz of the Center for Medicare Advo9cacy told Ashford. Without a Medigap plan, you face higher co-pays and uncapped out-of-pocket costs. It’s essential to do your research and talk to an expert before choosing a plan.

So, Should You Switch Medicare Advantage Plans?

There are some circumstances – Ashford calls them “red flags” – that mean you should probably change your coverage. “If your primary care physician or primary hospital system is now out of network, for instance, you’ll want to look for a plan that includes them,” she writes.

We would add a strong recommendation from Rajiv Nagaich that your plan should allow you to see a geriatrician as your primary care doctor. If you find a doctor you want to start seeing, check his or her website or call the office and ask about Medicare Advantage coverage and which insurance plans they honor.

As noted above, inadequate prescription coverage may also be a reason to switch plans. “If an expensive medication isn’t covered, see if there’s a plan that includes it,” says Ashford. “You can input your medications into the plan finder on to see options.”  Make sure, when you’re estimating drug costs, that you check details such as dosage and generic versus name brand options carefully and accurately.

Get Good Advice and Seek Out Free Assistance

Regardless of your situation, Ashford and the experts she spoke with do not advocate switching plans without good, solid reasons. But whatever you decide, she concludes, “do your homework during Medicare’s fall open enrollment from October 15th to December 7th.  The research you do today will help you avoid surprises in 2025.

Remember, too, that states have free advice available through a program called the State Health Insurance Assistance Program. Here in Washington State the program with its network of regional offices is run through the Office of the Insurance Commissioner.

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(originally reported at

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