When Should You Consider Switching Your Medicare Plan?

Posted by Shawna Moore, RICP, FSCP
Estimated Reading Time 1 minute 26 seconds

Choosing the right Medicare plan is essential for meeting your healthcare needs and managing costs effectively. However, as healthcare needs and Medicare plans evolve, you might wonder if it’s time to reconsider your current coverage. Considering these situations when switching your Medicare plan could be a smart move.

Your Health Needs Have Changed

If your health needs have changed significantly over the past year—whether due to a new diagnosis, additional medications, or the need for specialized care—it may be time to review your plan. Medicare Advantage and Part D (prescription drug) plans vary in their coverage and network providers, so switching plans can help you align your coverage with your current health requirements.

Your Current Plan’s Costs Are Increasing

Medicare plan costs, including monthly costs,  copayments, and deductibles, can change annually. If you’ve noticed an increase in your out-of-pocket expenses, it’s worth reviewing your current plan with other options during the Annual Enrollment Period (October 15 to December 7).  You might find a plan with lower out of pocket costs and similar coverage that better fits your budget.

Your Provider or Pharmacy Is No Longer in the Network

If you’re on a Medicare Advantage plan or a Part D plan and your preferred provider or pharmacy is no longer in-network, it could result in higher costs for your care. Ensuring your doctors, specialists, and pharmacies remain in-network helps you avoid unexpected costs, so if you’ve encountered changes in your network, consider switching plans.

You Qualify for a Special Enrollment Period

Outside the Annual Enrollment Period, some situations qualify for a Special Enrollment Period, like moving out of your plan’s service area or losing other insurance coverage. During these times, you can switch plans to one that better fits your needs.

If you’re wondering whether switching Medicare plans is the right choice for you, contact us today and speak with a licensed insurance agent to schedule a free plan review. We’ll help you evaluate your options to ensure your coverage meets your needs effectively.