If you’re steamed to discover your favorite doctor is no longer in your Medicare Advantage plan’s network, now is the time to make a change.
Medicare Advantage enrollees can switch plans or transfer to original Medicare during the open enrollment period ending March 31. You cannot, however, jump from a traditional Medicare plan to a Medicare Advantage one. You’ll have to wait for the fall enrollment period for that move.
“I call this the ‘buyer’s remorse’ enrollment period,” Philip Moeller, a Medicare expert and the author of “Get What’s Yours for Medicare,” told Yahoo Finance.
“Reviewing Medicare Advantage coverage and possibly switching makes sense this year,” he said. “There were many changes to 2025 plans, including to drug plans and reductions by some plans in their coverage of routine dental, hearing, and vision care.”
This can be alarming if you’re not paying attention.
Medicare Advantage plans are an alternative health insurance program to traditional Medicare for those 65 and older. They’re run by private insurance companies such as UnitedHealthcare and Humana and have been soaring in popularity in recent years.
Enrollment in 2025 is projected to be 35.7 million — more than half of all people enrolled in Medicare.
A big draw of Medicare Advantage plans is that they include coverage for benefits not included in traditional Medicare, such as drug coverage (Part D), eyeglasses, dental coverage, and fitness classes. Plus, they often have very low or even no premium costs.
That can be enticing. This year, original Medicare’s monthly Part B premiums are $185, and the annual Part B deductible, which most people must pay before their Medicare coverage begins, is now $257.
There are disadvantages. Unlike original Medicare, depending on the Advantage plan, you’re limited to a specific network of doctors and other healthcare providers, and those networks are ever-changing.
It’s not unusual to be referred to a specialist who is not part of your Medicare Advantage plan network. In those cases, you need prior authorization to make an appointment, or simply be prepared to pony up and pay the bill out-of-pocket.
Therein lies the No. 1 motivation for people to jump plans: to have access to the healthcare providers they currently use or plan to.
“A reason people should review their plan options is they might not have realized that one of their providers is now out of network, and they’ve lost access to (their) preferred doctor, or maybe they didn’t realize that a copay for a regularly scheduled visit increased for this year,” Meredith Freed, a senior Medicare policy manager at KFF, told Yahoo Finance.
