enroll
Medicare Advantage Open Enrollment
In the event that you change your mind about a Medicare Advantage Plan for any reason, the Medicare Advantage Open Enrollment Period from January 1 to March 31 gives you the opportunity to make changes.
Yes, you can drop a Medicare Advantage plan and return to Original Medicare, but don't count on a Medigap plan if that is your intention. Remember that carriers will screen you and can choose not to enroll you.
Switch from one Medicare Advantage Plan to Another
Drop Medicare Advantage and return to Original (Parts A & B) Medicare
Add a Part D prescription plan
Drop a Part D prescription plan
Parts of Medicare
One of your first choices.
You must be enrolled in both Part A and Part B to elect an Advantage plan, and you continue to pay your Part B premium. Medicare pays the plan administrator a set monthly amount to manage your care, and the plan delivers all of your benefits. You also must live within the plan's coverage area.
Advantage plans tend to evolve year over year. Beneficiaries get the opportunity to review their plan annually and choose one that best suits their anticipated needs for the upcoming coverage year.
Original Medicare
Parts A & B
Federal coverage with deductibles and a 20% co-insurance on Part B. You can access care from any doctor or hospital that accepts Medicare, which most do.
Medicare Advantage
Part C — often includes Part D
Combines Part A and Part B benefits — frequently with prescription drug coverage — managed by a private insurer through a network of providers in your area.
Original vs. Advantage
How you access your benefits.
Under Original Medicare, you're subject to deductibles and a 20% co-insurance on Part B, with the freedom to use any provider that accepts Medicare.
Under a Medicare Advantage plan, you access care through a network in your coverage area. Co-pays vary by service: some plans charge a per-day co-pay for hospital stays, others a flat amount for the entire stay.
The benefit
A safety net for catastrophic costs.
Before Medicare Advantage existed, beneficiaries on Original Medicare who couldn't afford a Medigap plan sometimes faced overwhelming medical bills after a serious illness.
Advantage plans were created as a safety net for catastrophic expenses, with an out-of-pocket spending cap. Once you reach the limit, the plan covers eligible medical expenses for the rest of the year (Part D is calculated separately).
Many Advantage plans also include Part D, so you don't need to purchase a separate prescription drug plan.
Original vs. Advantage
A safety net for catastrophic costs.
Before Medicare Advantage existed, beneficiaries on Original Medicare who couldn't afford a Medigap plan sometimes faced overwhelming medical bills after a serious illness.
Advantage plans were created as a safety net for catastrophic expenses, with an out-of-pocket spending cap. Once you reach the limit, the plan covers eligible medical expenses for the rest of the year (Part D is calculated separately).
Many Advantage plans also include Part D, so you don't need to purchase a separate prescription drug plan.
Provider preferences
Are you attached to specific providers? Do they accept Medicare Advantage or only Original Medicare?
Hospital network
What types of insurance are accepted at your preferred hospital?
Travel & lifestyle
Do you frequently travel out of your coverage area or split time between homes?
Risk tolerance
How much variability in monthly healthcare costs feels comfortable to you?
Plan structures
HMO vs PPO.
The summaries above are a cursory guide. Working with a licensed insurance professional is still the best way to find a Medicare policy that suits your needs and budget.
HMOa
Health Maintenance Organization
You select an in-network Primary Care Physician who coordinates your care and must be seen first for non-emergency needs. Specialist visits require a referral.
HMOs often come with the lowest premiums, but they're less flexible with provider choice and out-of-pocket costs can vary.
ppo
Preferred Provider Organization
No primary care doctor required — you can self-refer to specialists. Both in-network and out-of-network options are available.
PPOs offer more flexibility, but premiums can run higher. A broker can help you shop for the best fit for your circumstances.
Ready when you are
Talk with a licensed advisor today.
Personalized guidance — no obligation, just clarity.