Should I Switch Medicare Plans? 4 Questions to Ask Before Changing Plans

If you’re unhappy with your current Medicare plan…

Or, you’ve found another plan available in your area that seems like it could be a better fit for you…

Wait. 

Because switching Medicare plans is not something you want to rush. 

There are mistakes you can make, plans you could get locked out of, and even deceptive sales tactics you could fall for. 

After helping people with Medicare for over 15 years, we’ve seen plenty of people switch without fully understanding how it affected their coverage, and regret their decision later on. 

We don’t want that to happen to you. 

So in this article, we’ll go over everything you need to know before switching: from how to compare your current plan with your options, to Medicare’s confusing rules for switching. 

4 Things to Consider When Switching Plans

Before you make the switch, ask yourself these four questions:

#1: Does The New Plan Cover Your Doctor?

Medicare Supplement Plans cover all doctors that participate in Medicare. If your doctor takes Medicare (which 98.4% of non-pediatric doctors in the United States do), they should also take your Medicare Supplement Plan. 

Meanwhile, Medicare Advantage Plans have networks of doctors and hospitals that they work with. 

Before joining a Medicare Advantage Plan, it’s important to check the plan’s network to see if your preferred doctors and hospitals are covered. 

Some Medicare Advantage Plan types, such as Health Maintenance Organizations (HMOs), usually don’t cover you for out-of-network doctors (except during emergencies). 

Others, like Preferred Provider Organizations (PPOs), typically cover out-of-network doctors for higher out-of-pocket costs on your end. 

#2: Does The New Plan Cover Your Prescription Drugs?

All Medicare Part D plans (both standalone prescription drug plans (PDP) and Medicare Advantage Prescription Drug Plans (MAPDS)) have a list of prescription drugs that they cover. This is known as the plan’s formulary. 

Before joining a new plan, it’s important to check if your prescription drugs are included in the plan’s formulary, and how much they cost per refill. 

It’s also important to understand that, in most cases, you can’t have both a standalone Medicare Part D plan and a Medicare Advantage plan at the same time.

Standalone Part D plans are typically paired with Original Medicare, often alongside a Medicare Supplement plan. 

So if you switch from Medicare Supplement to a Medicare Advantage plan, you’ll generally be automatically disenrolled from your standalone Part D plan if you have one.

(Note: this applies unless your Medicare Advantage Plan is a Private-Fee-For-Service [PFFS] or a Medical Savings Account [MSA] type)

#3: Does Your New Plan Cost More?

When comparing Medicare Plans, there are generally four costs you should compare:

1. Premiums – The monthly cost of the plan. Medicare Supplement Plans generally have higher premiums when compared with Medicare Advantage Plans. Many people who choose Medicare Supplement also enroll in a standalone Medicare Part D plan, which has its own separate premium. Meanwhile, many Medicare Advantage Plans have lower or $0 premiums, and many already have drug coverage included. 

2. Deductibles – Deductibles are the amount you have to pay out-of-pocket before your plan’s coverage kicks in. Medicare Advantage Plans and Part D Plans may set their own deductibles (up to certain limits). Medicare Supplement Plans don’t have their own deductibles, but depending on the plan letter, they may not cover some of Original Medicare’s deductibles (such as the Medicare Part B deductible, which costs $283 in 2026). 

3. Copays and Coinsurance – Plans may make you pay a fixed dollar amount for a covered service (copay), or a percentage of the bill (coinsurance). Check your plan’s Summary of Benefits to see how much certain services will cost you. 

4. Maximum Out-of-Pocket Limit (MOOP) – This is the most you can spend out-of-pocket for the year. Medicare Advantage Plans can set their own MOOPs (up to certain limits), while all Medicare Part D Plans have a set $2,100 MOOP in 2026. Most Medicare Supplement Plans (such as Plan G) technically don’t have a MOOP. But since your out-of-pocket spending with Plan G is only the Medicare Part B deductible ($283 in 2026), you could argue that this is your MOOP. 

When comparing costs, try checking how much you’ll spend in a year without any doctor visits (premiums only), a year with a few doctor visits and procedures, and a year where you stay at the hospital for weeks and max out your plan. 

Comparing numbers for different scenarios will give you a better idea if the plan you want to join is a better fit for you. 

#4: Does Your New Plan Have Extra Benefits? 

Original Medicare does not cover most dental care, eye exams for prescription eyeglasses, hearing aids, and several other health-related services. 

However, many Medicare Advantage Plans have extra perks that cover these and more. You can find plans that offer Flex Cards for groceries, gym memberships, transportation benefits, over-the-counter benefits, Medicare Part B premium reduction, etc.

Coverage for extra perks varies widely from plan to plan, so make sure to read through the plan’s Summary of Benefits. 

Meanwhile, Medicare Supplement Plans typically don’t provide extra perks. Some plans may offer gym memberships, but their extra perks are usually not as plentiful as Medicare Advantage Plans. 

Once you’ve considered these four things, you should have a much better idea if the plan you want to join is actually a better fit for you than your current plan. 

But before you make the switch, there are several rules to be aware of. 

Medicare Enrollment Periods and Rules for Switching Plans

The enrollment periods when you can switch (and the rules for switching between Medicare plans) depend on what type of plan you currently have and what type of Medicare plan you want to join. 

Medicare Advantage to Medicare Advantage

You can typically switch from one Medicare Advantage Plan to another during the Annual Enrollment Period, the Medicare Advantage Open Enrollment Period, and any Special Enrollment Period that you qualify for. 

The Annual Enrollment Period (AEP) runs from October 15 to December 7 every year. During this time, you can join any Medicare Advantage Plan available in your area. Plan changes you make during this period will take effect on January 1 of the following year. 

The Medicare Advantage Open Enrollment Period (MA OEP) starts on January 1 and ends on March 31 every year. During this time, you can switch from one Medicare Advantage Plan to another. However, you cannot join a Medicare Advantage Plan during this period if you don’t already have one. Plan changes made during this period take effect on the 1st day of the following month. 

Special Enrollment Periods (SEPs) allow you to join a Medicare Advantage Plan outside the normal enrollment periods. However, these only come up in certain scenarios. Some of the more common ones include: 

• You move out of your Plan’s service area
• You become eligible or ineligible for Medicaid 
• Your current plan leaves Medicare

Plan changes made during Special Enrollment Periods typically take effect on the first day of the following month. 

Medicare Supplement to Medicare Advantage

If you’re switching from Original Medicare with a Medicare Supplement Plan to a Medicare Advantage Plan, you can usually do so during the Annual Enrollment Period (AEP) from October 15 to December 7 every year, or if you qualify for a Special Enrollment Period. 

However, you cannot switch from Original Medicare + a Supplement Plan to a Medicare Advantage Plan during the Medicare Advantage Open Enrollment Period (January 1 – March 31). That enrollment period is only for people who are already on Medicare Advantage Plans. 

Also, keep in mind that if you have a standalone Medicare Part D drug plan, you will automatically be disenrolled from it should you join a Medicare Advantage Plan (unless the Advantage Plan you join is a Private-Fee-For-Service or a Medical Savings Account). 

Medicare Advantage to Medicare Supplement

To switch from a Medicare Advantage plan to a Medicare Supplement plan, you’ll need to leave your Medicare Advantage plan and return to Original Medicare. Once you’re back on Original Medicare, your Medicare Supplement coverage can begin.

You can leave Medicare Advantage during the Annual Enrollment Period (October 15 – December 7), the Medicare Advantage Open Enrollment Period (January 1 – March 31), and during any Special Enrollment Period that you qualify for. 

However, in most states, switching from a Medicare Advantage Plan to a Medicare Supplement Plan may require you to pass medical underwriting. 

The Medicare Supplement Plan may ask about your health history and medications you’re taking. And they can decline your application based on your answers. 

However, there are situations where you can switch from Medicare Advantage to Medicare Supplement without passing medical underwriting: 

• Medigap Open Enrollment Period – The Medigap Open Enrollment Period is a one-time window that generally all Medicare beneficiaries get. It allows you to join any Medicare Supplement Plan available in your area with no questions asked. The Medigap Open Enrollment Period typically starts the first day of the month your Medicare Part B becomes effective (as long as you’re 65+), and ends six months after that.

• Guaranteed Issue (GI) Rights – Guaranteed Issue Rights allow you to join a Medicare Supplement Plan without medical underwriting if you go through a qualifying event. You typically get GI rights if your Medicare Advantage Plan closes, you move out of your plan’s coverage area, or a few other situations. 

• Trial Rights – Trial Rights allow you to “try” Medicare Advantage for one full year without the normal risk of getting locked out of Medicare Supplement due to medical underwriting. You get trial rights if you join a Medicare Advantage Plan when you’re first eligible for Medicare, or if you start on Medicare Supplement and join Medicare Advantage for the first time. 

• State Laws – States like Connecticut, Maine, Massachusetts, New York, and Rhode Island have local laws that allow you to switch from Medicare Advantage to Medicare Supplement without underwriting either year-round or during certain enrollment periods in the state. 

Medicare Supplement to Medicare Supplement

You can switch from a Medicare Supplement Plan to another Medicare Supplement Plan at any time of the year. You will typically need to pass medical underwriting to do this. However, several states have special rules that allow you to switch between Medicare Supplement Plans without underwriting. 

States like Connecticut, Maine, New York, and Vermont allow you to switch from one Medicare Supplement Plan to another at any time of the year with no questions asked. 

Other states, like California, Delaware, Idaho, Illinois, Indiana, Kentucky, Louisiana, Maryland, Nevada, Oklahoma, Oregon, Utah, Virginia, West Virginia, and Wyoming, have “Birthday Rules” that allow you to switch without underwriting around your birthday. 

Some of these states typically only allow you to join the same plan letter as your current plan (Plan G to Plan G, Plan N to Plan N) or to a lesser plan letter (Plan G to Plan N, but not Plan N to Plan G). Other states typically only allow you to switch to a plan sold by the same insurance company as your current plan. 

So be sure to look up your state-specific rules before trying to switch during your birthday. 

Finally, Massachusetts, Rhode Island, Missouri, and Minnesota also allow you to switch without medical underwriting during certain periods of the year. 

State rules are constantly evolving, so be sure to check with your local state department of insurance to see if your state has adopted or updated any guaranteed issue protections. 

Frequently Asked Questions About Switching Medicare Plans

Can I Switch Medicare Plans Anytime of the Year?

The answer is often no. 

You can only change Medicare plans anytime if you currently have a Medicare Supplement Plan and want to join another Medicare Supplement Plan. But you may have to pass medical underwriting to do this. 

Otherwise, for Medicare Advantage plans, you can typically switch during the Annual Enrollment Period (October 15 – December 7), the Medicare Advantage Open Enrollment Period (January 1 to March 31), and any Special Enrollment Period you qualify for. 

What’s the Difference Between the Annual Enrollment Period and the Medicare Advantage Open Enrollment Period? 

The Annual Enrollment Period (AEP) allows you to join any Medicare Advantage plan available in your area.  The Medicare Advantage Open Enrollment Period (MA OEP) only allows you to switch to a Medicare Advantage plan if you’re already on Medicare Advantage. 

You can make as many plan changes as you want during the Annual Enrollment Period. Generally, whichever the last plan you enroll in during this period will be the one to take effect on January 1 of the following year. 

During the Medicare Advantage Open Enrollment Period, you can only make one plan change. Your new plan should take effect on the first day of the following month you make the change. 

Both enrollment periods allow you to disenroll from Medicare Advantage and return to Original Medicare. 

If I Switch From Medicare Supplement to Medicare Advantage, Will I Lose My Part D Drug Plan?

Usually, yes. 

Standalone Medicare Part D prescription drug plans (PDPs) usually cannot co-exist with Medicare Advantage Plans (whether the Advantage Plan has built-in drug coverage or not). 

However, standalone Medicare Part D Plans can work with Private-Fee-For-Service (PFFS) and Medical Savings Account (MSA) Medicare Advantage Plans.  

What is the Medigap Open Enrollment Period?

The Medigap Open Enrollment Period is a one-time, six-month window that allows you to join any Medicare Supplement Plan in your area with no questions asked. 

It starts when your Medicare Part B coverage begins, and runs for six months. 

Want More Guidance on Whether to Switch Plans? 

Checking your Medicare plan options can be a wonderful opportunity to find a plan that’s a better fit for you. 

However, if you’re not careful, switching plans on your own can leave you with a plan that doesn’t cover your doctors, your drugs, or costs you a lot more than you expected. 

That’s why it’s so important to know the rules around switching—and, in the case of Medicare Advantage, to have software that can look up which doctors are “in network” for which plans.

If you’d like more help comparing your plan options, our team of licensed insurance agents would be glad to assist at no cost to you. 

Call or text us at +1 877-360-6565 (TTY: 711), or click on the button below to schedule an appointment.