Can I change my Medicare drug plan anytime?

No, you generally can't change your Medicare drug plan (Part D) anytime; you must use the Annual Election Period (Oct. 15 - Dec. 7) for coverage starting Jan 1, or a Special Enrollment Period (SEP) if you qualify (like moving, losing other coverage, or getting Extra Help), with specific rules for each period. If enrolled in a Medicare Advantage Plan, you also have the MA Open Enrollment Period (Jan. 1 - Mar. 31) to switch drug plans, but it often involves changing your whole Medicare Advantage plan, notes Medicare Interactive.

When can I change my Medicare prescription drug plan?

You can primarily change your Medicare Part D prescription drug plan during the Annual Enrollment Period (AEP) from October 15 to December 7, with changes taking effect January 1. If you have a Medicare Advantage Plan (MAPD), you get an extra chance during the MA Open Enrollment Period (Jan 1 - Mar 31) to switch plans or return to Original Medicare with a separate Part D plan. You may also qualify for a Special Enrollment Period (SEP) for specific life events. 

What is the best drug plan for seniors on Medicare?

There's no single "best" Medicare drug plan (Part D) for all seniors; it depends on your specific medications, budget, and preferences, but top-rated providers often include UnitedHealthcare (AARP), Humana, Wellcare, and Aetna, with strengths like low premiums (Cigna), diabetes care (Humana), or value (Wellcare). The most effective method is to use the official Medicare Plan Finder (Medicare.gov) to compare local plans based on your personal drug list for 2026. 

Can I drop my Medicare Advantage plan and go back to original Medicare?

Yes, you can drop your Medicare Advantage (MA) plan and return to Original Medicare, typically during the Annual Enrollment Period (AEP) (Oct 15–Dec 7) or the MA Open Enrollment Period (OEP) (Jan 1–Mar 31), though you may qualify for a Special Enrollment Period (SEP) if you move or have other qualifying life events, but be aware you'll need to get a Part D plan and might want a Medigap plan to help with costs. 

Is the Medicare Part D donut hole going away in 2025?

Next, check the pharmacy benefit for your plan to see what you will have to pay for each covered drug. Third, know that in 2025, the coverage gap (also called the “donut hole”) is going away and you will not have to pay anything for your covered drugs once you have paid $2,000 in out-of-pocket costs.

How Do I Change My Medicare Part D Drug Plan? - Medicare Made Simple Guide

How to avoid the Medicare Part D donut hole?

First, you can opt for generic medications instead of name-brand ones. Second, see if your doctor can give you free samples, and third, you might consider paying cash for your more expensive meds. These are just a few of the things you can do to avoid the donut hole stage.

What is the difference between a donut and a donut hole?

However, the size difference between donut holes and full donuts is also significant. A typical donut has a diameter of 72 to 82 millimeters with an 11 millimeter hole in the center. A donut hole, by contrast, averages under an ounce in weight, which is just about the size of the hole in the middle of a full donut.

Is there a penalty for switching from Medicare Advantage to original Medicare?

No, there's no direct penalty for switching from Medicare Advantage (Part C) back to Original Medicare (Parts A & B), but you risk significant issues: losing drug coverage (Part D penalty if you don't enroll in a separate plan) and potentially being denied or paying much more for a Medigap supplement due to medical underwriting after your initial guarantee period ends. You must switch during specific enrollment periods (Annual Election Period: Oct 15-Dec 7, or MA Open Enrollment: Jan 1-Mar 31). 

Why are people opting out of Medicare Advantage plans?

People are leaving Medicare Advantage (MA) plans due to difficulty accessing care (like provider network limits, prior authorizations), dissatisfaction with care quality, issues with plan generosity, and challenges with specific plans, especially as their health needs grow, often leading them back to Original Medicare for broader choice but sometimes finding it hard to switch. Healthier individuals might join for perks, but sicker enrollees often face network restrictions, approval hurdles, and poor experiences, prompting disenrollment, notes KFF and ElderLawAnswers. 

What is the best health insurance for seniors on Medicare?

There's no single "best" health plan, as it depends on your needs, but top providers for Medicare Advantage (Part C) include Humana, UnitedHealthcare, Aetna, and BCBS, offering diverse benefits like $0 premiums, extra perks, and strong networks, while Medigap (Medicare Supplement) complements Original Medicare by filling gaps, with popular carriers like AARP/UHC, Anthem, and Cigna providing standardized policies (Plans G, F, N), with personalized choices best found via your State SHIP counselor or broker. 

Is GoodRx better than Medicare Part D?

Neither GoodRx nor Medicare Part D is universally "better"; they serve different purposes, and often work best together, with Medicare providing baseline coverage and GoodRx offering significant savings on specific drugs, especially generics, or when your plan doesn't cover a medication. You use GoodRx instead of Part D for a single prescription when its price is lower than your Part D copay, but Part D is essential for overall coverage, while GoodRx helps fill gaps or reduce costs in the coverage gap (donut hole). 

What are the biggest mistakes people make with Medicare?

The biggest Medicare mistakes involve missing enrollment deadlines, failing to review plans annually, underestimating total costs (premiums, deductibles, copays), not enrolling in a Part D drug plan with Original Medicare, and assuming one-size-fits-all coverage or that Medicare covers everything like long-term care. People often delay enrollment, get locked into old plans without checking for better options, or overlook financial assistance programs, leading to higher out-of-pocket expenses and penalties. 

Is Blue Cross or UnitedHealthcare better?

UnitedHealthcare gets slightly higher overall star ratings than BCBS and may offer lower prices, but BCBS might offer a better customer experience.

What is the best prescription drug plan for seniors?

There's no single "best" Medicare Part D plan; it depends on your specific drugs and needs, but top-rated insurers often include UnitedHealthcare (AARP), Humana, and Cigna/Evernorth, praised for satisfaction, low costs, or perks, while you should compare plans on the official Medicare Plan Finder using your medication list, budget, and preferred pharmacies. Key factors are your drug formulary (list), monthly premium, deductible, copays, and network coverage, with 2026 plans having a $2,100 out-of-pocket max and $35 insulin cap. 

Can you drop Part D and buy it later?

Yes, you can drop Medicare Part D and buy it later, but you'll likely face a late enrollment penalty (a higher premium for life) if you go 63 or more days without other creditable drug coverage, unless you qualify for a Special Enrollment Period (SEP) or Extra Help (low-income subsidy). You can change plans during the Annual Enrollment Period (Oct 15 - Dec 7), but dropping it entirely means you risk paying more later if you don't have other coverage. 

What is the 7 month rule for Medicare?

This is called your Initial Enrollment Period. It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65. My birthday is on the first of the month.

Is it better to have straight Medicare or a Medicare Advantage plan?

Neither Original Medicare nor Medicare Advantage (MA) is inherently "better"; the best choice depends on your health, budget, and lifestyle, with Original Medicare offering provider freedom and MA providing bundled benefits (dental/vision) and cost predictability via an out-of-pocket maximum, but often with network restrictions. Choose Original Medicare + Medigap for nationwide access and no networks, ideal for travelers or those wanting maximum choice, while Medicare Advantage suits those wanting all-in-one coverage (including drugs/extras like dental/vision) with lower upfront costs and a cap on yearly spending, provided they stay in-network. 

Which Medicare Advantage plan denies the most claims?

Centene (Wellcare) and CVS Health (Aetna) have faced scrutiny for high prior authorization denial rates in Medicare Advantage (MA) plans, with reports showing they had the most denied requests in 2023, though many denials were overturned on appeal, indicating issues with their strict criteria, while UnitedHealthcare also faces lawsuits and uses technology that has led to increased denials, especially for post-acute care, highlighting systemic challenges with MA plan claim approvals. 

What changes are coming to Medicare in 2025?

In 2025, the biggest Medicare changes involve Part D, including a $2,000 annual cap on out-of-pocket prescription drug costs, elimination of the coverage gap (donut hole), and new options to spread drug costs monthly, alongside increases in Part B premiums ($185/month) and deductibles, and a higher Part A deductible ($1,676), continuing significant cost-sharing reforms from the Inflation Reduction Act. 

How to switch medicare part D plans?

To switch Medicare Part D plans, use the Annual Enrollment Period (Oct 15-Dec 7) to find a better fit using the Medicare Plan Finder (medicare.gov), or use the Medicare Advantage Open Enrollment (Jan 1-Mar 31) if you have an MA plan, or qualify for a Special Enrollment Period due to life events like moving. You can switch online via Medicare.gov or plan websites, by calling 1-800-MEDICARE, or directly with the new insurer; your old plan automatically ends when the new one starts. 

What is the most highly rated Medicare Advantage plan?

There's no single "most highly rated" Medicare Advantage plan nationwide, as ratings vary by location and insurer, but Kaiser Permanente often leads in integrated care markets (like CA) for high CMS & J.D. Power scores. Aetna gets high marks for nationwide reach & ratings, while UnitedHealthcare, Humana, and SCAN Health Plan are consistently strong performers with high CMS Star Ratings and member satisfaction, often offering $0 premium options and extra benefits. 

What is the 3 month rule for Medicare?

Generally, you're first eligible to sign up for Part A and Part B starting 3 months before you turn 65 and ending 3 months after the month you turn 65. (You may be eligible for Medicare earlier, if you get disability benefits from Social Security or the Railroad Retirement Board.)

Did Biden eliminate the donut hole?

Did you know that, as of January 1, 2025, there is no longer a Coverage Gap Phase for those with Part D Prescription Drug coverage? The former coverage gap, also known as the “donut hole,” was eliminated as part of the Biden Administration's Inflation Reduction Act.

What does the 🍩 mean in slang?

The 🍩 doughnut emoji or slang word has multiple meanings, commonly referring to actual doughnuts, junk food, police officers (as their stereotype), Homer Simpson, or, as an insult, someone foolish or an idiot (especially in UK/Commonwealth slang), but can rarely imply something sexual or be used to replace "do not" (don'ut). 

Will Medicare ever get rid of the donut hole?

As of 2025, the Medicare Part D “donut hole” no longer exists – meaning there is no longer a coverage gap during which Part D enrollees face higher drug costs. The “donut hole” was eliminated thanks to provisions of the Affordable Care Act (ACA) and the Inflation Reduction Act (IRA).