No, you cannot change Medicare plans at any time. Changes are generally restricted to specific, authorized periods, primarily the Annual Enrollment Period (Oct 15–Dec 7) or, in certain cases, Special Enrollment Periods (SEPs) due to qualifying life events like moving.
You generally won't face a penalty for switching Medicare Advantage (MA) or Part D plans during enrollment periods (like AEP: Oct 15-Dec 7 or MA OEP: Jan 1-Mar 31). However, potential issues arise if you drop Part D (prescription drug) coverage for 63+ days, triggering a late enrollment penalty, or if you switch from MA to Original Medicare and can't get Medigap due to health issues (underwriting). Penalties usually apply for late enrollment into Part B or D, not for switching plans at the right time.
Here are some of the biggest Medicare mistakes to avoid:
You can make changes to your plan each year during Medicare's Open Enrollment Period and the Medicare Advantage Open Enrollment Period. The only time you can change your Medicare Advantage plan outside of the usual enrollment periods is if you qualify for a Special Enrollment Period (SEP).
There are no ``penalties'' going back to original Medicare as you've always had Medicare even while in a Medicare advantage plan. Penalties are for those who disenroll from part b completely which you haven't done.
People leave Medicare Advantage (MA) plans due to difficulty accessing needed care (especially with worsening health), restrictive provider networks, complex prior authorization rules, and dissatisfaction with care quality, often feeling trapped as their health needs grow despite initial low costs and extra perks that become limiting. Issues with provider availability, network changes, and sometimes misleading marketing also drive disenrollment, pushing people back to Traditional Medicare for greater freedom, notes KFF.
If you're already in a Medicare Advantage plan and you want to switch to traditional Medicare, you should contact your current plan to cancel your enrollment and call 1-800-MEDICARE (1-800-633-4227). Note there are specific enrollment periods each year to do this.
Yes, if you are already in a Medicare Advantage (MA) plan, you can switch to another MA plan or return to Original Medicare during the Medicare Advantage Open Enrollment Period (MA OEP), which runs from January 1 to March 31 each year, so you can switch in January 2025. This allows current MA members to make one change, like switching MA plans or dropping MA for Original Medicare (with or without a Part D plan), with coverage starting the first day of the next month.
The Medicare "3-Day Rule" requires a beneficiary to have a qualifying 3-day inpatient hospital stay (admission day counts, discharge day doesn't) before Medicare will cover services in a Skilled Nursing Facility (SNF) for rehabilitation or skilled care, though this rule can be waived in certain Medicare Advantage plans or through specific Accountable Care Organization (ACO) initiatives. Time spent in observation or the Emergency Department doesn't count towards these 3 days, but new demonstration projects and waivers are emerging to offer more flexibility for patients needing SNF care.
Vermont, Utah and Minnesota topped the Commonwealth Fund's Medicare performance scorecard in 2025, whereas Kentucky, Mississippi and Louisiana struggled the most.
Annual enrollment period — Oct.
You have many options to change coverage during annual open enrollment. You can switch to a different Medicare Advantage plan, change from an MA plan to original Medicare and vice versa, or switch from one Part D drug plan to another. Your coverage begins Jan.
Less freedom in choosing health care providers.
In some areas, it can be difficult to find a local doctor or hospital that works with Medicare Advantage. And if you visit a doctor or a hospital that isn't “in-network,” you will pay higher out-of-pocket costs.
Disenroll from your plan and return to Original Medicare anytime between January 1 – March 31. If you disenroll and return to Original Medicare, you are also given a Special Election Period (SEP) to enroll in a Part D plan during this time.
Your CalPERS health coverage will automatically be canceled the first day of the month after you turn 65. Review Cancellation of CalPERS Health Coverage for information on reinstating your health coverage.
Medicare policy is that for a patient to be considered inpatient, then the stay should exceed two midnights. There are few exceptions to this rule. Death and inpatient claims, where a procedure is performed that is on the inpatient only list, being two.
Starting in 2025, there is an annual limit on what you pay out-of-pocket for prescription medications through Medicare and Medicare Advantage prescription drug plans. All prescription medications, including specialty medications, covered by Part D plans are included under this cap.