Can I switch Medicare Advantage plans every year?

Yes. During the Annual Enrollment Period, October 15 to December 7, or during the Medicare Advantage Open Enrollment Period, January 1 to March 31, if you are already enrolled in an Advantage plan.

Can I leave Medicare Advantage and buy a Medicare Supplement later?

You can leave the Advantage plan during AEP or the Advantage Open Enrollment Period. Being approved for a Medigap policy is separate. Outside your 6-month Medigap Open Enrollment Period at 65 and certain guaranteed-issue situations, most states allow insurers to review your health history and decline you.

Is insulin capped at $35 on Medicare Advantage plans?

Covered insulin is capped at $35 a month under any Part D plan, whether it is standalone or bundled into a Medicare Advantage plan. Check that your specific insulin is on the plan formulary.

Medicare Advantage Help: Understand Your Options and Choose the Right Coverage With Confidence

Q: What is Medicare Advantage?

Medicare Advantage, or Part C, is an alternative to Original Medicare offered by private insurers approved by Medicare. You stay enrolled in Medicare and keep paying your Part B premium. The plan delivers your Part A and Part B benefits, and usually includes Part D drug coverage plus extras like dental, vision, and hearing.

Q: What is the maximum out-of-pocket on a Medicare Advantage plan?

Every Medicare Advantage plan has an annual cap on what you pay for Part A and Part B services. The federal limit sits above $9,000 for in-network care, and some PPO plans have higher combined in-network and out-of-network limits. Many plans set their limit well below the federal maximum.

Q: My Medicare Advantage plan is being discontinued. What are my options?

You can choose another Medicare Advantage plan, return to Original Medicare with a Part D plan, or use your guaranteed-issue Medigap right to buy a Supplement with no health questions. That right is time-limited and many people are unaware of it.

Reviewed by Scott Bowling, licensed independent Medicare broker. Texas License #2882146. Last reviewed September 2026. Medicare Advantage plans can offer powerful benefits, but they can also be confusing, restrictive, and costly if you choose the wrong one. Many people enroll based on low monthly premiums or flashy extra benefits, only to discover later: – Their doctors are no longer covered – Prescription costs are higher than expected – Copays add up quickly – Coverage rules are more restrictive than they realized With major Medicare changes landing for 2027, choosing the right Medicare Advantage plan matters more than ever. At Trusted SR Solutions, we help individuals and families clearly understand Medicare Advantage, compare real costs, avoid common mistakes, and select coverage that actually fits their healthcare needs and budget.

Big Changes Are Coming for 2027

A Million People Are Losing Their Plan

More than a million Medicare Advantage members nationwide are losing their plan for 2027. Several major carriers are discontinuing plans, and the non-renewal letters go out in early October. If yours is one of them, your coverage ends December 31 and you have a deadline. The people who get hurt are the ones who set the letter aside.

If You Get a Non-Renewal Letter, You Have a Right Most People Never Hear About

When a Medicare Advantage plan is discontinued, federal law grants you a guaranteed-issue Medigap right. Insurers cannot reject you or charge you more for pre-existing conditions. That window is narrow and time-limited. Most people who get that letter simply take the replacement plan the carrier offers, and accepting it usually means giving up the one chance they had to buy a Supplement without answering a single health question. Before you accept anything, price a Medigap plan and verify the new coverage includes your doctors, your drugs, and your hospitals.

What We Are Watching in 2027 Plan Documents

Longer inpatient hospital copay periods, with some plans extending a daily copay from the first 5 days to the first 7. Higher coinsurance on outpatient surgery, imaging, and certain therapies. Rising maximum out-of-pocket limits. Climbing skilled nursing facility copays. And the usual annual shuffle of provider networks and drug formularies.

Read Your Annual Notice of Change

It arrives by the end of September and lists exactly what is changing on your plan, including whether your plan is being discontinued. Most people set it aside. If you do one thing this fall, open it.

What Is Medicare Advantage (Part C)?

Medicare Advantage, also called Part C, is an alternative to Original Medicare offered by private insurance companies approved by Medicare. You stay enrolled in Medicare and keep paying your Part B premium. What changes is how your care is delivered and paid for. Instead of paying Medicare directly for each service, Medicare pays your Advantage plan a monthly amount to manage your care. These plans deliver: – Medicare Part A (hospital coverage) – Medicare Part B (medical coverage) Most Medicare Advantage plans also include: – Prescription drug coverage (Part D) – Dental – Vision – Hearing – Wellness benefits

Why Medicare Advantage Is So Popular, and Why It Requires Careful Review

Medicare Advantage plans attract millions of people because they often offer: ✔ Low or $0 monthly premiums ✔ All-in-one coverage ✔ Extra benefits not included in Original Medicare ✔ A built-in limit on medical spending

Cost Protections Many People Don’t Realize Exist

✔ $35 insulin cap, which applies to covered insulin under any Part D plan, whether standalone or bundled into an Advantage plan ✔ $0 preventive vaccines, including flu and shingles shots under Part D These benefits can make a major difference, but only if your specific medications and providers are covered correctly.

Key Features of Medicare Advantage Plans

Provider Networks

Most plans operate as HMO or PPO structures, which means in-network care is strongly encouraged and out-of-network care may cost more or not be covered at all. Networks change yearly. That is a major reason annual reviews matter.

Copays and Coinsurance

Instead of paying 20% like Original Medicare, plans typically use flat copays for visits, daily hospital charges, and procedure copays. Low premiums don’t always mean low total costs.

Annual Maximum Out-of-Pocket (MOOP)

Every Medicare Advantage plan has a yearly spending limit for medical services. The federal cap sits above $9,000 for in-network care, and some PPO plans have higher combined in-network and out-of-network limits. Many local plans we work with set their limit well below the federal maximum. We help you find plans with stronger financial protection.

Prescription Drug Coverage in Medicare Advantage

Most Advantage plans include Part D coverage.

The $2,400 Out-of-Pocket Drug Cost Cap

Once your covered prescriptions reach $2,400, you are protected from additional covered drug costs for the rest of the year. The annual Part D deductible is capped at $700. How quickly you reach that cap depends on plan design.

Prescription Cost Smoothing

The Medicare Prescription Payment Plan is optional. You must choose to opt in. It allows beneficiaries to spread drug costs across monthly payments instead of paying large amounts early in the year at the pharmacy counter. Some people benefit greatly from this. Others are better off sticking with standard copays. We help you decide which approach works best for your budget.

Common Medicare Advantage Mistakes We Help People Avoid

Choosing Based on Premium Alone

Low premiums can hide high yearly costs.

Not Checking Doctor Networks

Many people lose providers without realizing it.

Ignoring Drug Formularies

Medications may cost far more year to year.

Overlooking Coverage Restrictions

Prior authorizations and referrals can delay care.

Assuming You Can Switch to a Supplement Later

This is the most expensive assumption in Medicare. You can leave a Medicare Advantage plan during AEP or the Advantage Open Enrollment Period. Being approved for a Medigap policy is a separate question. Outside your 6-month Medigap Open Enrollment Period at 65 and a few guaranteed-issue situations, most states let insurers review your health history and decline you.

Who Medicare Advantage Works Best For

It may fit well if you: ✔ Are comfortable using networks ✔ Want lower monthly premiums ✔ Prefer bundled coverage ✔ Are generally healthy or moderate users ✔ Value extra benefits

Who Should Be Cautious

It may not be ideal if you: ⚠ Travel frequently or spend months in another state ⚠ Want full provider freedom ⚠ Have complex medical needs ⚠ Want predictable long-term costs

When You Can Change Medicare Advantage Plans

Annual Enrollment Period (AEP)

October 15 to December 7. Switch Advantage plans, return to Original Medicare, or change your Part D plan. Changes take effect January 1.

Medicare Advantage Open Enrollment Period (OEP)

January 1 to March 31. If you are already in an Advantage plan, switch to a different one or return to Original Medicare. You cannot use this window to join Medicare Advantage for the first time.

Special Enrollment Periods

Triggered by life changes such as moving out of your plan’s service area, losing coverage, or having your plan discontinued.

How Trusted SR Solutions Helps

We are independent advisors focused on what fits you.

Step 1, review your situation

Doctors, medications, costs, concerns.

Step 2, compare your best options

We review the top plans in your area to find the right fit.

Step 3, explain real costs clearly

Premiums, copays, MOOP, drug expenses.

Step 4, help you enroll smoothly if a better plan exists

Correct timing, clear expectations, no pressure.

Frequently Asked Questions

Are Medicare Advantage plans bad?

No. They work well for many people. They have to be chosen carefully, and they have to be reviewed every year, because the plan you signed up for is not necessarily the plan you will have in January.

Do $0 premium plans really cost nothing?

No. You still pay your Part B premium, and you pay copays and coinsurance when you use services. Your total cost depends on how much care you use during the year.

Can I switch plans every year?

Yes, during AEP from October 15 to December 7, or during the Advantage Open Enrollment Period from January 1 to March 31 if you are already in an Advantage plan.

My plan is being discontinued. What are my options?

You can pick another Medicare Advantage plan, return to Original Medicare with a Part D plan, or use your guaranteed-issue Medigap right to buy a Supplement with no health questions. That last option is time-limited and most people never hear about it.

Can I leave Medicare Advantage and get a Supplement later?

You can leave the Advantage plan. Getting approved for a Supplement is a separate question, and outside specific protected windows most states allow medical underwriting. Check this before you assume it is an option.

Get Personalized Medicare Advantage Help

Trusted SR Solutions helps you: ✔ Compare clearly ✔ Avoid costly mistakes ✔ Understand what is changing ✔ Enroll confidently Contact Trusted SR Solutions today for clear, unbiased Medicare Advantage guidance. Call Scott Bowling directly at 512-844-3983, or pick a time and I’ll call you. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. We are not connected with or endorsed by the United States government or the federal Medicare program.