Medicare Advantage

Medicare Advantage Open Enrollment in Clemmons, NC

People in Clemmons can choose from 97 Medicare Advantage plans for 2027, against 99 this year. 15 of this year’s plans are gone, 13 are new to Forsyth County, and 41 that continue have changed their premium, deductible, plan type or name, 16 of them under a new name.

CLEMMONS, N.C. — If you signed up for a Medicare Advantage plan last fall and it isn't quite what you expected, you have a second chance. From January 1 through March 31, the Medicare Advantage Open Enrollment Period gives you one shot to change course without waiting until next fall.

This window is smaller and quieter than the big Annual Enrollment Period that ends December 7, but for people already in a Medicare Advantage plan, it can be a real safety net.

What this window is — and who it's for

The Medicare Advantage Open Enrollment Period (sometimes called MA-OEP) is only for people who are already enrolled in a Medicare Advantage plan on January 1. If that's you, you can use these three months to:

• Switch to a different Medicare Advantage plan (with or without drug coverage).
• Drop your Medicare Advantage plan and go back to Original Medicare (Parts A and B).
• If you go back to Original Medicare, join a stand-alone Part D prescription drug plan.

You cannot use this window to move from Original Medicare into a Medicare Advantage plan for the first time. That change usually has to wait for the fall Annual Enrollment Period (October 15 – December 7) or a Special Enrollment Period.

One change — make it count

Unlike the fall enrollment window, where you can change your mind again and again until December 7, the January–March window allows just one change. Whatever choice you make sticks, and it takes effect the first day of the month after your request is processed.

That means it pays to compare carefully before you submit anything. Look at:

• Whether your doctors and hospitals are in the plan's network.
• Whether your regular prescriptions are on the plan's drug list.
• How the plan handles referrals, prior authorization, and out-of-area care.

Local context: plans in Forsyth County

Clemmons is in Forsyth County, where Medicare beneficiaries have a range of Medicare Advantage and Part D options to choose from. Plan availability, networks, and drug formularies are set at the county level, not the town level — so two neighbors in Clemmons will see the same menu of plans, but a friend across the county line may see something different.

You can see the full list for your ZIP code using the Plan Finder tool at medicare.gov.

2027 numbers worth knowing

Even if you don't change plans, a few program-level updates take effect in 2027:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once your prescription drug spending hits that amount, you pay nothing for covered drugs the rest of the year.
• Part D maximum deductible: $615 in 2026 ($700 in 2027).
• The coverage gap ("donut hole") is gone as of 2025. Part D now has three phases instead of four.
• Medicare Prescription Payment Plan: an optional program that spreads your yearly drug costs into monthly payments, rather than charging you at the pharmacy counter.
• IRMAA surcharges (higher Part B and Part D premiums for higher earners) begin above $109,000 in income for a single filer in 2026.

Getting unbiased help

You don't have to figure this out alone, and you don't have to rely on a sales call. Free, unbiased help is available:

• Medicare.gov — for plan comparisons and official rules.
• 1-800-MEDICARE (1-800-633-4227) — 24/7, for personal questions about your coverage.
• North Carolina SHIIP — the state's Seniors' Health Insurance Information Program offers free one-on-one counseling with trained volunteers.