When Can I Change Medicare Plans?
Angela Davis

Jun 02 2025 20:00

Medicare shouldn't be confusing-here's a clear timeline you can trust

 

If your Medicare plan isn't fitting your doctors, prescriptions, or budget anymore, you're not stuck forever-but timing matters. Different enrollment windows allow you to switch Medicare Advantage, Part D, or Medigap coverage without penalties or surprises. At Eagle Group Associates, we help Oklahomans understand when they can change plans, what they can change, and how to do it smoothly-so your coverage works the way you need it to.

 

Quick refresher: what we mean by "changing Medicare plans"

 

Medicare has several parts and two main "paths" to coverage. Knowing which one you have determines how and when you can switch.

 

  • Original Medicare (Parts A & B) from the federal government
    • Optional Part D drug plan (stand-alone prescription plan)
    • Optional Medigap (Medicare Supplement) policy to reduce A/B out-of-pocket costs; no networks-see any provider who accepts Medicare
  • Medicare Advantage (Part C) from private insurers
    • Bundles Parts A & B and often Part D
    • Uses provider networks (HMO/PPO) and sets an annual out-of-pocket maximum
    • Often includes extras like dental, vision, or fitness perks

 

"Changing plans" could mean switching Advantage plans, moving from Advantage to Original Medicare(or vice versa), changing your Part D plan, or applying for a Medigap policy.

 

Why timing matters: the stakes are real

 

  • Cost: The "wrong" plan can mean higher copays, uncovered prescriptions, or surprise bills.
  • Access: Networks change; if your doctor or hospital is out-of-network, care costs can jump.
  • Penalties: Missing key windows for Part B or Part D can trigger late enrollment penalties that last as long as you have the coverage.
  • Stability: Formularies and rules (like prior authorization) update annually-reviewing each fall can prevent unpleasant surprises in January.

 

 

The main enrollment windows (and what you can change in each)

 

1) Initial Enrollment Period (IEP)- around your 65th birthday

 

  • When: 7 months total (3 months before, the month of, and 3 months after your 65th birthday month).
  • You can:
    • Enroll in Parts A & B.
    • Choose an Advantage plan or enroll in Part D if staying on Original Medicare.
    • Apply for Medigap-your 6-month Medigap Open Enrollment starts the month your Part B begins (no health underwriting during this window).

 

Why it matters: If you don't have qualifying employer coverage and you delay, you could face lifelong penalties for Part B or Part D.

 

2) Annual Election Period (AEP)- Oct 15 to Dec 7 every year

 

  • You can:
    • Switch Medicare Advantage plans.
    • Switch Part D drug plans.
    • Move from Medicare Advantage to Original Medicare (and choose a Part D plan).

 

Effective date: Jan 1 of the following year.
Tip: This is your main chance each year to reset drug coverage and react to network/formulary changes for the coming year.

 

3) Medicare Advantage Open Enrollment Period (OEP)- Jan 1 to Mar 31

  • You can (once):
    • Switch from one Medicare Advantage plan to another Advantage plan, or
    • Drop Advantage and return to Original Medicare(and add a Part D plan).

 

You cannot: Join a Part D plan unless you are dropping Advantage and going back to Original Medicare.
Good for: Fixing an MA plan that isn't working after the new year starts.

 

4) Special Enrollment Periods (SEPs)- life events that open a window

 

Common SEPs include:

  • Move to a new county/state (different plan options)
  • Loss of employer or union coverage(or losing drug coverage that was "creditable")
  • Plan changes or errors(insurer termination, marketing violations)
  • 5-Star SEP(if a 5-star plan is available in your area, you can switch once between Dec 8 and Nov 30)
  • Dual-eligible/Extra Help(Medicaid or Low-Income Subsidy beneficiaries may change more frequently)
  • Chronic condition SEP(for certain Special Needs Plans)

 

 

Timing: Most SEPs last 2-3 months from the event. Document the event(move proof, termination letter, etc.) to avoid delays.

 

5) Medigap timing & "trial rights"

  • Medigap Open Enrollment: 6 months starting with your Part B effective month- no health underwriting.
  • Guaranteed Issue (GI) rights: You may have GI rights (no underwriting) in certain situations-for example, if you tried a Medicare Advantage plan for the first time and switch back to Original Medicare within the first 12 months("trial right"). You can buy certain Medigap plans without health questions.
  • Outside these windows: You can apply for Medigap any time, but underwriting may apply and approval isn't guaranteed.

 

 

Step-by-step: how to decide when and what to change

 

Step 1: List your doctors, hospitals & clinics

 

Include specialties and locations (e.g., "cardiologist at OU Health in OKC"). Networks are plan-specific.

 

Step 2: List your prescriptions & pharmacies

 

Name, dosage, frequency, brand/generic preference, and preferred pharmacy. Formularies and pharmacy tiers change yearly.

 

Step 3: Add your care expectations for the next 12 months

 

Ongoing therapies? Planned procedures? Expensive brand-name meds? This helps us estimate total cost, not just premiums.

 

Step 4: Identify your window

  • Turning 65 soon? You're in (or near) IEP.
  • It's fall? That's AEP(Oct 15-Dec 7).
  • It's Jan-Mar and you're on Advantage? Consider OEP.
  • Had a life change (move, loss of coverage)? Ask about SEP.

 

 

Step 5: Compare plans side-by-side

 

We'll evaluate:

  • Premiums, deductibles, copays
  • Max out-of-pocket(Advantage)
  • Networks for each provider you use
  • Formulary tiers& utilization rules (prior auth, step therapy)
  • Extras(dental/vision/hearing) vs your actual needs

 

 

Step 6: Enroll correctly & keep confirmations

 

Submit the right application for the right window, save confirmations, and watch for your ID cards and Evidence of Coverage.

 

Step 7: Set a fall reminder

 

Even if you love your plan, review each AEP; plans update benefits and formularies every year.

 

Real-world Oklahoma scenarios (and the best window to use)

  • "My insulin got expensive in January."
    If you're on Advantage, you can use OEP (Jan 1-Mar 31) to switch to another MA plan with better drug tiers-or return to Original Medicare and choose a Part D plan. If you're on Original Medicare with a stand-alone Part D plan, you generally must wait for AEP unless you qualify for an SEP or Extra Help.

 

  • "We moved from Tulsa to Edmond."
    A move triggers an SEP because plan availability changes by county. You can choose a local Advantage/Part D plan that includes your new providers.

 

  • "I'm retiring in June and losing employer coverage."
    You'll have a Part B SEP and a Part D SEP. You may also qualify for Medigap GI rights depending on your situation.

 

  • "My Advantage plan dropped my doctor."
    Depending on the timing and notices, you might qualify for an SEP. Otherwise, consider switching during AEP or OEP if eligible.

 

  • "I enrolled in an Advantage plan at 65 but want to switch back."
    If it's within your first 12 months on your first MA plan, you likely have a trial right to go back to Original Medicare and buy certain Medigap plans without underwriting.

 

  • "I qualify for Extra Help (Low-Income Subsidy)."
    You may have additional opportunities to change Part D or Advantage plans during the year.

 

 

Common issues people run into (so you can skip them)

 

  • Confusing AEP with OEP:
    • AEP (Oct 15-Dec 7) lets you change Advantage and Part D plans for Jan 1.
    • OEP (Jan 1-Mar 31) is only for people already on Advantage-you get one change.

 

  • Assuming COBRA counts like employer coverage:
    COBRA doesn't always protect you from Part B or Part D penalties. Ask before delaying enrollment.

 

  • Focusing only on premium:
    Lower premium doesn't equal lower total cost. Consider specialty copays, drug tiers, and the maximum out-of-pocket.

 

  • Not documenting SEP events:
    Moves, coverage loss, or plan errors need proof(lease, utility bill, employer letter). Missing documents can delay approval.

 

  • Skipping the Rx check:
    Formularies change yearly. Always rerun your medications during AEP.

 

How Eagle Group Associates helps (and why local support matters)

 

  • We verify your doctors & hospitals-by name and location-against plan networks serving Oklahoma County and the surrounding communities.
  • We run your prescriptions through multiple plan formularies to reveal real out-of-pocket expectations (copays, tiers, prior auth).
  • We identify your correct window(IEP, AEP, OEP, SEP, trial right, Medigap GI)-and handle the paperwork.
  • We compare total cost of care, not just premiums-so you see the true financial picture.
  • We manage the details: applications, document uploads, confirmations, and follow-through with carriers.
  • We conduct annual reviews each fall to catch plan changes before January.

 

 

Our goal is simple: the right plan, at the right time, with no guesswork.

 

Your next step: let's confirm your window and options

 

If your plan isn't working-or you're just not sure-start with a quick conversation. We'll confirm your enrollment window, compare plans that fit your doctors and prescriptions, and guide you through a simple, stress-free switch.

 

Call (405) 602-1554 or contact us online to schedule your no-cost Medicare plan review. Bring a list of your doctors and medications-we'll handle the rest.

 

Proudly serving Oklahoma City & beyond

 

Eagle Group Associates serves Oklahoma City and neighboring communities, including Edmond, Norman, Moore, Yukon, Mustang, Midwest City, and Del City. Whether you prefer a face-to-face visit near South OKC or a quick phone appointment, we're here to help you change Medicare plans clearly, confidently, and affordably.