How to Switch Medicare Plans During AEP

Switching plans during AEP is straightforward, but the decision needs research. Start by reviewing your current costs, prescription coverage, and provider networks — then compare options.

Step 1: Review what you're paying now

Start with your current plan. Look at your 2026 premium, deductible, copays, coinsurance, and out-of-pocket maximum. If you take prescriptions, note the costs — copays or coinsurance — you're paying now.

Gather your last 12 months of medical claims if available. This shows your actual usage pattern and helps predict what you'll pay under other plans.

Step 2: Check your doctors and pharmacies

Pull the provider network for each plan you're considering. Call your doctors' offices and confirm they're in the network — don't rely on a list alone, as status can change.

Verify your pharmacy is in-network. Mail-order prescriptions may be covered differently, so check the specific formulas and costs for drugs you take.

Step 3: Compare costs, not just premiums

A lower premium doesn't mean lower total cost. Compare your expected annual out-of-pocket spending (premiums + deductibles + copays) across all plans you're considering.

Use Medicare.gov's plan comparison tool, plug in your prescriptions, and let the calculator estimate your costs under each option.

Step 4: Decide and enroll

Once you've chosen, enroll through Medicare.gov, by phone (1-800-MEDICARE), or with a licensed agent. Confirm your enrollment with a confirmation letter from your plan.

You do not need to notify your old plan — the switch is automatic when your new plan's coverage starts on January 1.

Frequently asked questions

Do I need to tell my current plan I'm leaving?

No. When your new plan's coverage starts January 1, your enrollment in the old plan automatically ends. You do not need to submit a termination letter.

Can I switch back if I change my mind?

Only during the next AEP (October 15 – December 7) or if you have a qualifying life event. After January 1, your new plan is your coverage for the year.

What if my doctor doesn't accept my new plan?

You likely have a Special Enrollment Period to switch plans if your doctor leaves your network after you've enrolled. Confirm with Medicare.

How do I know if a drug is covered?

Check the plan's formulary (drug list) on Medicare.gov or the plan's website, or call the plan directly. Costs vary by coverage tier.

General educational information only, not medical, legal, or tax advice. Plan networks, formularies, and costs can change. Verify all details directly with the plan before enrolling.

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