What Is the Medicare Advantage Open Enrollment Period?

Did you know that in 2023, nearly 1 in 5 Medicare Advantage beneficiaries made changes to their plans during the Open Enrollment Period (OEP)?

This annual window, running from January 1 to March 31, offers an opportunity for those already enrolled in a Medicare Advantage plan to re-evaluate their coverage and check if it meets their needs.

With the right information and guidance, this period could be the key to a more tailored and cost-effective Medicare experience.

In this blog, we’ll break down everything you need to know to make confident, informed decisions during this period.

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Understanding the Medicare Advantage Open Enrollment Period (OEP) The Medicare Advantage Open Enrollment Period (OEP) is an important time frame that allows current Medicare Advantage beneficiaries to review and adjust their healthcare coverage.

Healthcare needs can evolve over time, with factors such as new medical conditions, changes in prescription medications, or adjustments in provider networks influencing the suitability of a plan.

According to a recent study, nearly 45% of Medicare beneficiaries say they don’t fully understand their plan’s coverage until they start using it.

This statistic highlights the importance of taking advantage of OEP to avoid surprises and ensure satisfaction with your coverage.

Key Changes You Can Make During OEP Between January 1 and March 31, those enrolled in a Medicare Advantage plan can make the following key changes:

1. Switch To a Different Medicare Advantage Plan If your current plan no longer meets your expectations — whether due to network limitations, coverage gaps, or rising costs — you can transition to another Medicare Advantage plan.

This flexibility ensures you can find a plan that aligns with your healthcare requirements, including features like improved prescription drug coverage or expanded provider networks.

2. Revert To Original Medicare If you prefer the freedom and simplicity of Original Medicare, OEP allows you to leave your Medicare Advantage plan.

Additionally, you may also enroll in a standalone Part D Prescription Drug Plan during this time to maintain drug coverage, as Original Medicare does not include this benefit.

3. Address Coverage Gaps or Dissatisfaction OEP serves as a corrective measure for those who realize their current Medicare Advantage plan doesn’t fully address their needs.

Whether it’s unexpected out-of-pocket costs, lack of access to preferred providers, or reduced benefits, this period gives beneficiaries a chance to pivot to better coverage options for their needs.

4. What You Can’t Do During OEP While OEP offers significant flexibility, it’s important to understand its limitations.

You cannot switch from Original Medicare to a Medicare Advantage plan during this period. You cannot join a new standalone Part D Prescription Drug Plan unless you are leaving Medicare Advantage and returning to Original Medicare. And you can only switch once during the three-month time period.

As of 2025, the Medicare Advantage Open Enrollment Period (OEP) maintains its established guidelines, offering specific flexibilities and limitations for beneficiaries

Who Can Use the Medicare Advantage Open Enrollment Period? While eligibility is specific, there are nuances to consider beyond the basics.

Here’s who this period is for:

Current Medicare Advantage enrollees only: This period is exclusively for those already enrolled in a Medicare Advantage plan. It includes beneficiaries with plans that have or do not have prescription drug coverage. Not for new enrollments into Medicare Advantage: OEP does not allow individuals on Original Medicare (Parts A and B) to switch to Medicare Advantage. It also doesn’t enable those without Medicare Advantage to join for the first time. One change only: Beneficiaries can make a single adjustment to their coverage during the OEP window, which includes switching to a new Medicare Advantage plan or returning to Original Medicare. OEP is especially beneficial if:

You recently enrolled in a plan : If you chose a Medicare Advantage plan during the Annual Enrollment Period (AEP) and it doesn’t meet your expectations, OEP allows you to make corrections. You went through life changes: A shift in health needs, moving to a new location, or changing financial circumstances can prompt a re-evaluation of your plan during this time. You discovered plan changes : If your current plan altered its network, benefits, or costs starting in the new year, OEP is a chance to ensure your coverage still aligns with your priorities New to Medicare?

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How To Evaluate Your Current Medicare Advantage Plan During OEP The Medicare Advantage Open Enrollment Period (OEP) offers a valuable opportunity to take a closer look at your current plan and decide whether it’s still the best fit for your healthcare needs.

Here’s what you should do to evaluate your current Medicare Advantage Plan:

1. Review Plan Costs and Coverage Start by analyzing the financial aspects of your Medicare Advantage plan.

Ask yourself these questions:

Are your monthly premiums, deductibles, and copayments manageable within your budget? Are you encountering unexpected out-of-pocket costs that strain your finances? Does your plan provide sufficient coverage for the healthcare services you use most frequently, like doctor visits, hospital stays, or specialist appointments? By identifying gaps in your current plan, you can decide if switching to a more cost-effective or comprehensive option is necessary.

2. Check Provider and Pharmacy Networks Your plan’s network of healthcare providers and pharmacies plays a crucial role in your care.

Consider the following:

Is your primary care physician and any specialists you see regularly still in-network? Have any of your preferred pharmacies been excluded from the plan's network, increasing your costs or limiting your access to medications? Are you planning to move or travel frequently? If so, does your plan include adequate nationwide coverage? Networks can change annually, so it’s essential to verify that your current providers and pharmacies remain accessible.

3. Compare Prescription Drug Coverage Medications are a significant factor in healthcare planning.

When evaluating your plan during OEP, review:

Does your plan cover all your current prescriptions? Have there been changes to your plan’s formulary (the list of covered drugs), or are there restrictions like prior authorizations or quantity limits? Are you paying more for your prescriptions due to higher copayments or coinsurance?

Medications often make up a significant portion of healthcare expenses, so it’s crucial to evaluate how well your current plan aligns with your needs

Know About Crucial Enrollment Dates With Healthpilot At Healthpilot, we help you understand your eligibility for enrollment periods.

The Medicare Advantage Open Enrollment Period is your opportunity to make changes to your plan to align with your healthcare needs.

We simplify the process with our user-friendly platform, featuring:

Personalized recommendations : Receive insights tailored to your specific doctors, medications, and healthcare requirements. Plan comparison tools : Explore different plans side by side to review costs and benefits clearly. Clear and accessible support : Navigate the complexities of Medicare plans with confidence, knowing that assistance is always available. Ongoing evaluations : Our platform helps you review your plan annually to ensure it evolves with your changing healthcare needs. With Healthpilot, you can approach the Medicare Advantage Open Enrollment Period fully prepared. Our goal is to provide the clarity and guidance you need — free of charge and without any pressure to enroll.

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