Medicare Advantage

South Bend Medicare Advantage Members Get a Second Window

SOUTH BEND, Ind. — The clock is already ticking on one of Medicare's most important — and most misunderstood — second-chance windows. From January 1 through March 31, people enrolled in a Medicare Advantage plan get one shot to change course. If you missed something during fall enrollment, or your new plan isn't fitting the way you hoped, this is the window that lets you fix it before the calendar closes on you.

What this window is (and what it is not)

The Medicare Advantage Open Enrollment Period, often shortened to MA-OEP, is different from the fall Annual Enrollment Period. Fall AEP (October 15 – December 7) is open to almost everyone on Medicare. MA-OEP is narrower: it is only for people who are already enrolled in a Medicare Advantage plan on January 1.

If you have Original Medicare only, this window is not for you. And if you have Original Medicare plus a stand-alone Part D drug plan, you cannot use MA-OEP to switch that Part D plan.

What you can actually change between January 1 and March 31

If you are in a Medicare Advantage plan, during MA-OEP you may:

• Switch to a different Medicare Advantage plan (with or without drug coverage).
• Drop your Medicare Advantage plan and return to Original Medicare. If you do this, you may also add a stand-alone Part D prescription drug plan.

You get one change during this window. Once you make it, that's the move for the season. Choose carefully.

What you cannot do here:

• You cannot use MA-OEP to join a Medicare Advantage plan for the first time if you had Original Medicare on January 1.
• You cannot switch from one stand-alone Part D plan to another.
• You cannot pick up a Medigap (Medicare Supplement) policy with guaranteed acceptance in most cases — medical underwriting rules may apply in Indiana, so ask before you drop a Medicare Advantage plan expecting to buy a Medigap plan later.

How the dates interact

Think of the Medicare year as having three main doors:

1. Annual Enrollment Period (Oct. 15 – Dec. 7): Open to everyone with Medicare. Changes take effect January 1. 2. Medicare Advantage Open Enrollment (Jan. 1 – March 31): A one-time do-over for people already in a Medicare Advantage plan. Changes generally take effect the first of the month after the plan gets your request. 3. Special Enrollment Periods (any time they apply): Triggered by life events — moving out of your plan's service area, losing other coverage, qualifying for Extra Help, entering or leaving a nursing facility, and more.

If you make a change during AEP and then discover in February that your doctor is not in-network or your medication is not covered the way you thought, MA-OEP is the safety valve. That is exactly what it is designed for.

What happens if you miss March 31

If March 31 passes and you have not made a change, your current Medicare Advantage plan generally stays in place for the rest of the year. To make a different choice, you would have to wait for the next AEP in the fall — unless a Special Enrollment Period opens for you.

That is a long time to live with a plan that is not working. If you are unsure, do not wait until the last week of March to start comparing.

South Bend specifics

South Bend is in St. Joseph County, where availability of Medicare Advantage and Part D plans is set at the county level. That means neighbors across the state line in Michigan may see a different set of choices than you do, even if their ZIP code feels close by. When you shop, use your South Bend ZIP code on Medicare's Plan Finder so the results reflect what is actually offered in St. Joseph County.

A few program-level facts worth keeping in mind as you compare:

• The Part D out-of-pocket cap is $2,100 in 2026. Once your covered drug costs reach that amount, you pay $0 for covered Part D drugs the rest of the year.
• The Part D deductible cannot exceed $615 in 2026.
• The old coverage gap ("donut hole") is gone as of 2025. Part D now has three phases: deductible, initial coverage, and catastrophic.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly bills instead of paying big amounts at the pharmacy counter.
• IRMAA (higher Part B and Part D premiums for higher earners) kicks in above $109,000 in income for a single filer in 2026.

A simple checklist before you switch

• Pull out your current plan's Evidence of Coverage and Annual Notice of Change.
• List your doctors, hospitals, and preferred pharmacy. Confirm they are in-network in any plan you are considering.
• List every prescription with dosage. Check each one on the plan's formulary.
• If you rely on a specific specialist at Beacon Health System, Saint Joseph Health System, or another local provider, verify the network before you sign anything.
• If drug costs are your main concern, ask about the Medicare Prescription Payment Plan.

Where to get unbiased help

You do not have to figure this out alone, and you should not rely on a mailer or a TV ad as your main source.

• Medicare.gov — Use the Plan Finder with your South Bend ZIP code and your drug list.
• 1-800-MEDICARE (1-800-633-4227), available 24/7.
• Indiana SHIP (State Health Insurance Assistance Program) offers free, unbiased one-on-one counseling. Call 1-800-452-4800 to be connected with a local counselor who serves St. Joseph County.