Open Enrollment Is Here: 3 Signs It’s Time to Change Your Medicare Advantage Plan

Medicare enrollees have the opportunity to change their health insurance coverage each year during fall enrollment, which runs from October 15th to December 7th. If you use Medicare Advantage, you may be wondering whether it’s worth signing up for a new plan for 2025. Here are a few signs that you should at least consider switching.

1. Your costs are increasing

Many retirees live on a tight budget and little flexibility. If this is your situation and the cost of your Medicare Advantage plan is increasing in 2025, then that alone is a reason to look at other plan options.

You may particularly want to consider purchasing a new plan if Social Security’s cost of living adjustments are not enough to cover this increase in costs. Next year, benefits are expected to increase by 2.5%. But if your monthly benefit isn’t that high to begin with, it may not be that big of an increase.

2. Your benefits will be reduced

The advantage of choosing Medicare Advantage over original Medicare is that you may gain access to a variety of services that would not otherwise be covered. According to the Kaiser Family Foundation, by 2024, 97% or more of Medicare Advantage plans will offer dental, vision, hearing or fitness benefits.

And these are considered more “standard” benefits for Medicare Advantage plans. Some plans go well beyond these perks and include services like home cleaning and meal delivery.

However, if your Medicare Advantage plan loses some of these additional benefits in 2025, you may want to make a switch. Having to pay out of pocket for certain services could hurt your finances more than paying a higher premium for an Advantage plan with more coverage.

3. Your favorite providers are leaving the network

Once you get used to seeing certain providers, it can be difficult to make a switch. And if you have limited access to transportation, losing your preferred provider could mean struggling to take care of your health.

If your favorite doctors aren’t included in your plan next year, it might be time to think about getting a new Medicare Advantage plan. If you have even more providers to choose from, you may want to forego Advantage altogether and switch to Original Medicare.

However, keep in mind that original Medicare does not cover services such as dental, vision and hearing services. You’ll also need to sign up for a Part D drug plan in addition to original Medicare.

You should also know that Medicare Advantage plans typically have a deductible maximum that limits your annual spending, but Original Medicare plans do not. And although you can purchase supplemental insurance (Medigap) as an original Medicare enrollee, you may find it difficult to get affordable coverage if you choose to do so after being covered by an Advantage plan. You may also have to complete a waiting period for a Medigap plan to cover certain medical conditions you have.

Choosing a new Medicare Advantage plan can be overwhelming. So don’t wait until the end of the open enrollment period to get started. Start reviewing your options in the coming weeks if it’s clear you need a change. This way, you can go through the process without undue stress and avoid having to make a quick decision that ends up being the wrong one.