Not Happy With Your Medicare Advantage Plan? You Have Options
Feeling Stuck in Your Medicare Advantage Plan? The General Enrollment Period Is Your Way Out
I often talk to people every January who tell me the same thing: "I signed up for this Medicare Advantage plan during Annual Enrollment, and now that I'm actually using it, I realize it's not working for me." If that sounds familiar, I have good news. There's a special window just for you.
What Is the Medicare Advantage Open Enrollment Period?
From January 1st through March 31st each year, there's a period specifically designed for people who are already in a Medicare Advantage plan and want to make a change. We call it the General Enrollment Period, and honestly, it's a lifesaver for so many of my clients.
Here's what you can do during this time:
Switch from your current Medicare Advantage plan to a different Medicare Advantage plan
Drop your Medicare Advantage plan altogether and go back to Original Medicare (Parts A and B)
And here's the best part—if you switch to another Medicare Advantage plan or go back to Original Medicare and enroll in a Prescription Drug Plan during this period. Your new coverage starts the first day of the month after your plan receives your request. So if you make the switch in January, you could have new coverage as soon as February 1st.
Who Can Use This Enrollment Period?
This window is only for people who are currently enrolled in a Medicare Advantage plan. That's the key requirement. You have to already be in a Medicare Advantage plan to use this enrollment period to make changes.
If you're on Original Medicare and want to join a Medicare Advantage plan, or if you're just turning 65 and enrolling for the first time, this isn't the right enrollment period for you. But if you're in a Medicare Advantage plan and having second thoughts? This is your time.
Why Do People Make Changes During This Period?
I've helped clients during this enrollment period, and I'll tell you the most common reasons they want to switch:
The provider network isn't working out. Maybe your favorite doctor isn't in the network, or you found out that a specialist you need isn't covered. This is probably the number one issue I hear about.
Unexpected costs are adding up. Sometimes those copays and coinsurance amounts look reasonable on paper, but when you're actually going to appointments and getting treatments, they add up faster than you expected.
The plan doesn't cover what you need. Perhaps you've had a health change since you enrolled, and now you need services or medications that your plan doesn't cover well.
You want the freedom of Original Medicare. Some people try Medicare Advantage and realize they'd rather have the flexibility to see any doctor who accepts Medicare without worrying about networks or referrals.
Going Back to Original Medicare? Don't Forget About Part D
Here's something really important: if you decide to drop your Medicare Advantage plan and go back to Original Medicare during this period, you can also join a standalone Part D prescription drug plan at the same time. In fact, I strongly encourage it.
Original Medicare doesn't include prescription drug coverage, so unless you have coverage from somewhere else (like a former employer), you'll want to sign up for Part D. The good news is you can do this during the same enrollment period without any penalties.
One Change Per Year During This Period
Just so you know, you can only make one change during the General Enrollment Period each year. So if you switch from one plan to another in January, you can't switch again in February. Choose carefully.
How I Can Help You Make the Right Move
Deciding whether to switch Medicare Advantage plans or go back to Original Medicare is a big decision. There's no universal "best" answer—it all depends on your specific health needs, your doctors, your prescriptions, and your budget.
When you work with me at Senior Choice Consulting, here's what we'll do together:
Review what's not working with your current Medicare Advantage plan
Look at other Medicare Advantage options in your area that might be a better fit
Compare the pros and cons of staying in Medicare Advantage versus switching to Original Medicare
If you're considering Original Medicare, find the right Part D plan for your prescriptions
Walk through all the costs so there are no surprises
I've been doing this long enough to know that what works great for one person might be completely wrong for another. That's why I never push anyone toward one option or another—I just help you see clearly what each choice means for you.
Time to Take Action?
If you're in a Medicare Advantage plan and feeling like it's not the right fit, don't wait. The Medicare Advantage Open Enrollment Period is from January 1st through March 31st, and this might be your best opportunity to make a change.
Even if you're not sure what you want to do yet, let's talk. Sometimes, just laying out all your options and talking through your concerns makes the right choice crystal clear. I'm here to help you figure out what works best for your situation—no pressure, no sales pitch, just honest, unbiased guidance.
Give me a call or schedule an appointment here. Let's make sure you have Medicare coverage that actually works for you.
Medicare rules are always evolving, so this information is current as of today. For personalized advice about your specific situation, let's sit down and talk it through. You can also visit Medicare.gov for official information.
Disclaimer: We do not offer every plan available in your area. Any information I provide is limited to the Medicare Advantage (HMO, PPO, and/or Part D) plans I do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE (TTY: 1-877-486-2048), or your local State Health Insurance Program (SHIP) to get information on all of your options.
