Choosing the right Medicare plan is essential for ensuring you have the coverage that best meets your medical and financial needs. However, as your health, budget and provider networks change, your current plan may no longer be the best fit.
Whether you’re facing rising costs, changing health care needs or a plan that no longer covers your prescriptions or doctors, it may be time to consider switching. Medicare offers several opportunities to change plans. Understanding when and how to switch can help you avoid unexpected expenses and ensure you receive the best possible care.
When Should You Change Your Medicare Plan?
You should consider switching your Medicare plan for multiple reasons, including:
— Health care needs. As your health evolves, you may need different doctors, specialists or medications, and your current plan may no longer be the best choice.
— Changes to plan benefits. Plans add or remove benefits from year to year, so don’t assume what you had before will stay the same. Before open enrollment, you’ll get a notice of these changes. Read it carefully to make sure you still have what you need.
— Cost increases. If the price of your plan increases, it’s a good idea to review your options to see if a different plan offers similar or better coverage at a lower price. You might switch for a lower premium if you anticipate minimal health care needs. Or, if you’d rather pay more each month but have your plan cover more right away, then look for a plan with a low or $0 deductible.
— Prescription drug coverage adjustments. Each year, plans update their formularies (covered drug lists), which may result in your medication being dropped, moved to a higher cost tier or requiring prior authorization.
— In-network provider limitations. If your plan no longer includes your health care provider, you might want to switch. Remember that most Medicare Advantage plans also limit coverage to a certain geographic area, which may no longer work for you if you or your doctor have moved.
— Extra benefits. Medicare Advantage plans often offer “extra” benefits not found in original Medicare. If you need medical benefits (such as dental, hearing and vision) or nonmedical benefits (such as gym memberships, caregiver support or transportation to medical appointments), consider switching.
If you are considering a change, find out what is in your area with Medicare’s online plan finder.
“Consumers should then call plans directly to confirm networks and drug pricing before enrolling. Plan finder information is not always accurate, and plan networks and drug prices can change over the course of a year,” advises Amanda Grady, lead benefit specialist and supervising attorney at the Elder Law and Advocacy Center of the Greater Wisconsin Agency on Aging Resources in Madison, Wisconsin.
[READ: Benefits Offered by Medicare Advantage]
2026 Enrollment Updates
Medicare beneficiaries can generally rely on the same enrollment windows year after year, but details can change behind the scenes. In 2025 and 2026, the Centers for Medicare & Medicaid Services (CMS) updated guidance and clarified certain rules that affect how and when plan changes can be made, especially for Medicare Advantage and special enrollment periods.
Dual eligibility enrollment updates
For people with dual eligibility (both Medicare and Medicaid), switching plans has been streamlined. It’s now easier to change Medicare Advantage coverage thanks to integrated “one-card” ID systems that automatically update Medicaid alignment. The CMS also introduced a monthly integrated care special enrollment period (SEP) that lets full-benefit beneficiaries switch plans only when enrolling in a fully integrated, highly integrated or applicable-integrated D-SNP (Dual-Eligible Special Needs Plan).
“Inaccurate Directory” SEP
A new “inaccurate directory” safeguard gives beneficiaries a do-over if a Medicare Advantage plan’s provider list is incorrect. If you enrolled through Medicare.gov because it showed your doctor was in-network but discover within the first three months that the information was wrong, you can make a one-time change. This protection allows you to switch to another plan that truly includes your doctor or return to original Medicare, so you’re not locked into coverage that doesn’t include the providers you rely on.
[READ: Medicare Advantage Initial Enrollment Period and Special Enrollment Periods]
Strengthened “trial rights” protection
CMS has strengthened “trial rights” to protect anyone trying a Medicare Advantage plan for the first time. If you leave your first Medicare Advantage plan within 12 months, you have a 60-day window to buy a Medigap plan without being denied for preexisting conditions.
[READ Medigap vs. Medicare Advantage: Which Should You Buy?]
When Can You Change Plans?
Understanding when you can switch your Medicare plan ensures you always have the best coverage for your health and financial situation. There are opportunities throughout the year, but different enrollment periods cover different circumstances.
“Medicare beneficiaries can change their coverage if certain events happen that trigger a special enrollment period. This would include if someone changes their address, recently lived in a facility such as a nursing home, lost their current coverage, gained eligibility for other coverage, is dually eligible for Medicare and Medicaid or other exceptional circumstances,” adds Gretchen Jacobson, vice president of the Medicare program for the Commonwealth Fund, a foundation focused on health care policy based in New York City.
Changing Medigap Plans
Changing Medigap plans can be a bit more complex than switching original Medicare or Medicare Advantage plans as some different rules apply.
The best time to sign up is during the one-time Medigap open enrollment period, which happens within the six months you turn 65 and enroll parts A and B. During this period, insurance companies cannot deny you coverage or charge you more due to preexisting health conditions. Outside of this period, an insurance company may use medical underwriting, which can lead to higher premiums or denial of coverage.
“There are some situations, however, outside of the Medigap open enrollment period where insurance companies cannot deny you a Medigap policy. These are called ‘guaranteed issue rights,'” Grady says, “For example, you have guaranteed issue rights if you lose Medigap through no fault of your own or you drop your Medigap plan to try a Medicare Advantage plan and decide to switch back within 12 months.”
Depending on your state, you may have additional rights worth exploring.
“Some states provide additional periods where beneficiaries can purchase Medigap without underwriting,” Jacobson explains. “They may specify these as Medigap open enrollment periods. As an example, Maryland provides an open enrollment period without underwriting during the 30 days following a Medigap policyholder’s birthday.”
How Can You Change Plans?
Here are a few ways you can change plans, including:
— Online. You can enroll online through Medicare.gov.
— Phone. Call 1-800-MEDICARE (1-800-633-4227).
— Plan’s website. Often plans allow you to enroll or leave directly through their website.
— With a licensed insurance agent. A licensed insurance agent can help you compare plans and make the switch.
Bottom Line
People may choose to change their Medicare plan if their health care needs, costs or coverage options have changed. Common reasons include rising premiums, changes in prescription drug coverage, losing access to preferred doctors or needing additional benefits.
Plan changes are limited to specific enrollment periods throughout the year, but a special enrollment period may be available in certain situations. Medigap plans may be changed outside of enrollment periods, but depending on the circumstances, there is no guarantee of coverage.
More from U.S. News
How to Use Medicare’s Telehealth Coverage
How and Why to File a Medicare Appeal
What to Do if AI Denies Your Medicare Claim or Prior Authorization
How to Change Medicare Plans in 2026: Dates, Rules and Expert Tips originally appeared on usnews.com
Update 03/11/26: This story was previously published at an earlier date and has been updated with new information.
