If you’re currently enrolled in a Medicare Advantage plan and you’ve been thinking about making a change, you’re in luck. The Medicare Advantage Open Enrollment Period started yesterday on January 1, 2026, and runs through March 31. This annual window gives you the opportunity to switch to a different Medicare Advantage plan or return to Original Medicare if your current coverage isn’t meeting your healthcare needs. Keep reading to learn if you qualify, what changes you can make, and important factors to consider before the deadline.
What Is Medicare Advantage Open Enrollment?
The Medicare Advantage Open Enrollment Period, commonly called the MAOEP, is a designated timeframe each year when Medicare Advantage enrollees can make specific changes to their coverage. It’s separate from the Annual Enrollment Period that takes place from October 15 through December 7, and it serves a different purpose. While the Annual Enrollment Period allows anyone with Medicare to make broad changes to their coverage, Medicare Advantage Open Enrollment is exclusively designed for people who are already enrolled in a Medicare Advantage plan.
This enrollment window exists because Medicare recognizes that sometimes beneficiaries need a second chance to adjust their coverage after the main enrollment season ends. Perhaps you enrolled in a plan during the fall only to discover in January that your preferred doctor isn’t in the network. Maybe you’ve found that your prescription costs are higher than expected, or the plan’s benefits don’t align with your medical needs. Medicare Advantage Open Enrollment provides a valuable opportunity to correct course without waiting another full year.
One critical rule to remember is that you’re limited to making just one change during this period. Once you’ve made your election, whether that’s switching to another Medicare Advantage plan or dropping your MA plan entirely, you can’t make additional changes until the next enrollment period. This means you should carefully evaluate your options before submitting any enrollment requests.
Changes You Can Make
During Medicare Advantage Open Enrollment, you have two primary options for changing your Medicare coverage. First, you can switch from your current Medicare Advantage plan to a different Medicare Advantage plan. This includes moving from an HMO to a PPO, changing to a plan with different benefits, or selecting a plan that includes your doctors in its network. Your new plan can include or exclude prescription drug coverage depending on your preferences and needs.
Second, you can disenroll from Medicare Advantage altogether and return to Original Medicare, which consists of Part A hospital coverage and Part B medical coverage. If you choose this route, you’ll also have the opportunity to join a standalone Medicare Part D prescription drug plan. This is an important consideration because Original Medicare doesn’t include prescription drug coverage on its own, and going without Part D coverage could result in late enrollment penalties if you decide to add it later.
It’s equally important to understand what you aren’t allowed to do during Medicare Advantage Open Enrollment. You can’t use this period to switch from Original Medicare to a Medicare Advantage plan. You also can’t join a Medicare Advantage plan for the first time. These actions must occur during Medicare’s Annual Enrollment Period or through a Special Enrollment Period if you qualify for one based on specific life circumstances.
Key Considerations for 2026
Several significant changes to Medicare in 2026 may influence your decision during this enrollment period. The annual out-of-pocket cap for prescription drugs covered under Part D has increased to $2,100, up from $2,000 in 2025. While this represents a slight increase, the cap still provides substantial protection against high medication costs. Once you reach this threshold, your plan covers 100% of your covered prescription costs for the remainder of the year.
The maximum Part D deductible for 2026 is $615, though many plans offer lower deductibles or none at all. Additionally, the coverage gap, commonly known as the donut hole, no longer exists. After meeting your deductible, you’ll pay 25% coinsurance for your medications until you reach the out-of-pocket maximum. The Medicare Prescription Payment Plan also continues in 2026, allowing you to spread your out-of-pocket drug costs across monthly payments rather than paying everything at the pharmacy counter. If you participated in this program in 2025, you’ll be automatically re-enrolled unless you opt out.
Another major development for 2026 is the implementation of negotiated drug prices for ten high-cost medications. Through the Medicare Drug Price Negotiation Program established by the Inflation Reduction Act, Medicare has secured lower prices on drugs treating conditions such as diabetes, heart failure, blood clots, and autoimmune diseases. These negotiated prices represent discounts of at least 38% from the 2023 list prices, potentially saving Medicare beneficiaries billions of dollars collectively. If you take medications like Eliquis, Jardiance, Xarelto, or Januvia, you may see significant savings under your Part D coverage this year.
For Medicare Advantage specifically, the maximum out-of-pocket limit for in-network services has decreased slightly to $9,250 in 2026, down from $9,350 in 2025. Average premiums for Medicare Advantage plans have also dropped to approximately $11.50 per month, though actual premiums vary depending on your location and the specific plan you choose.
Returning to Original Medicare
If you’re considering leaving Medicare Advantage to return to Original Medicare, there are several factors you should weigh carefully. Original Medicare offers broader provider access since most doctors and hospitals nationwide accept it. You won’t need referrals to see specialists, and you won’t be restricted to a specific network. However, Original Medicare has no annual out-of-pocket maximum, which means your costs could be substantial if you experience a serious illness or injury.
Many beneficiaries who return to Original Medicare also purchase a Medicare Supplement policy, commonly called Medigap. These policies help cover out-of-pocket costs like deductibles, copayments, and coinsurance. However, there’s an important caveat. If you’ve been enrolled in Medicare Advantage for more than 12 months, you may not have guaranteed issue rights to purchase a Medigap policy. Insurance companies in most states can deny you coverage or charge higher premiums based on your health history.
However, if you joined Medicare Advantage when you first became eligible for Medicare at age 65 and you’re switching back within your first year, you typically retain your right to buy a Medigap policy without medical underwriting. Otherwise, your ability to obtain affordable Medigap coverage may be limited depending on your state’s regulations and your health status.
You should also keep in mind that if your Medicare Advantage plan included prescription drug coverage and you switch to Original Medicare, you’ll need to enroll in a standalone Part D plan within 63 days to avoid potential late enrollment penalties.
Conclusion
The Medicare Advantage Open Enrollment Period running from January 1 through March 31, 2026, offers current MA plan members a focused window to reassess their healthcare coverage. Whether you’re looking to switch to a different Medicare Advantage plan that better fits your needs or you’re ready to transition back to Original Medicare, this enrollment period gives you the flexibility to make one important change. Understanding the rules, deadlines, and implications of your choices will help you select the coverage that works best for your health and financial situation.
As you evaluate your options during this enrollment period, take time to compare plan benefits, provider networks, prescription drug formularies, and total costs including premiums, deductibles, and out-of-pocket maximums. Consider how recent Medicare changes for 2026, including the new drug price negotiations and updated cost-sharing limits, might affect your healthcare expenses this year. If you’d like help finding the best Medicare Advantage plan for your healthcare needs and budget, please call 866-633-4427 to speak with a Senior Healthcare Solutions Medicare expert.
