Medicare Advantage
How Washington, PA Enrollees Can Change Medicare Advantage
WASHINGTON, Pa. — If you signed up for a Medicare Advantage plan during fall enrollment and are already having second thoughts, you still have time to make one change. The Medicare Advantage Open Enrollment Period runs January 1 through March 31, and it gives current Advantage members a second look at their coverage before spring.
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Key takeaways
- The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 and is only for people already enrolled in a Medicare Advantage plan on January 1.
- During this window, you can make one plan change, and the new coverage starts the first day of the month after the plan receives your request.
- This period is different from the fall Annual Enrollment Period (October 15 – December 7) and does not let you make all the same changes, such as switching between Medicare and certain other options freely.
- Before switching plans, check that your doctors, hospitals, and pharmacies are in the new plan’s network and that your medications are covered, since you are allowed to take time and ask questions before deciding.
Here is what this window is, what you can and cannot do during it, and the common mistakes to avoid.
What the Open Enrollment Period actually is
The Medicare Advantage Open Enrollment Period (often shortened to MA-OEP) is a three-month window each year for people already enrolled in a Medicare Advantage plan on January 1. Think of it as a course-correction period, not a general shopping season.
It is different from the fall Annual Enrollment Period (October 15 – December 7), when anyone with Medicare can review and change coverage. If you missed the fall window entirely, MA-OEP is more limited — but it is not nothing.
What you can change between January 1 and March 31
According to CMS guidance on Medicare.gov, during MA-OEP you can:
- Switch from one Medicare Advantage plan to another Medicare Advantage plan (with or without drug coverage).
- Drop your Medicare Advantage plan and return to Original Medicare (Parts A and B).
- Add a stand-alone Part D prescription drug plan if you drop back to Original Medicare.
You get one change during this window. Once you make it, that is your move for the season. The new coverage starts the first day of the month after the plan gets your request.
What you cannot do in this window
MA-OEP is narrower than fall enrollment. It does not let you:
- Switch from Original Medicare into a Medicare Advantage plan for the first time.
- Join or switch stand-alone Part D drug plans if you are staying on Original Medicare.
- Sign up for a Medigap (Medicare Supplement) policy with guaranteed acceptance — Medigap has its own rules, and outside your initial open enrollment, insurers in Pennsylvania can generally use medical underwriting.
If you are brand-new to Medicare, your Initial Enrollment Period around your 65th birthday still applies separately.
Local context for Washington
Washington is in Washington County, where Medicare Advantage plans and stand-alone Part D plans are offered by a range of private insurance carriers approved by CMS. Plan availability, provider networks, and drug formularies are set at the county level, so two neighbors in the same ZIP code generally see the same menu of plans. When you use the Plan Finder tool on Medicare.gov, entering your Washington ZIP code will pull the plans available in Washington County.
2027 numbers worth knowing
Whether you use this window or not, a few program-wide figures are worth writing down:
- $2,100 in 2026 and $2,400 in 2027 — the annual out-of-pocket cap on covered Part D prescription drugs. Once you hit it, you pay nothing for covered drugs the rest of the year.
- $615 in 2026 and $700 in 2027 — the maximum Part D deductible a plan can charge.
- The coverage gap ("donut hole") is gone. Part D now has three phases instead of four, a change that took effect in 2025.
- Medicare Prescription Payment Plan — an optional program that lets you spread your out-of-pocket drug costs across monthly payments instead of paying in big chunks at the pharmacy.
- IRMAA — higher-income surcharges on Part B and Part D begin above $109,000 in income for a single filer in 2026.
These figures are set by CMS and apply nationally, not by plan.
Common mistakes to avoid
Assuming you're stuck. A surprising number of people believe December 7 was their last chance. If you are already in an Advantage plan, you are not stuck until next fall.
Changing without checking the network. Before you switch, confirm your doctors, preferred hospitals, and pharmacies are in the new plan's network. In Washington County, network breadth varies plan-to-plan.
Forgetting your drugs. Log in to a plan's formulary (drug list) and check every medication you take, at the dose you take. A plan that looked cheap on premium can be expensive if a key drug is on a higher tier or not covered.
Making a snap decision on a phone call. You are allowed to take time, ask questions, and hang up. Nothing in MA-OEP requires a same-day answer.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in Washington County
(MA penetration in Washington County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
Key dates
Medicare enrollment periods at a glance
- Around your 65thInitial Enrollment PeriodA 7-month window around the month you turn 65 — your first chance to sign up.
- October 15 – December 7Annual Enrollment PeriodAnyone with Medicare can join, switch, or drop a Medicare Advantage or Part D plan.
- January 1 – March 31Medicare Advantage Open EnrollmentIf you're already in a Medicare Advantage plan, you can make one change.
- January 1 – March 31General Enrollment PeriodFor people who missed their first chance to sign up for Part B.
- VariesSpecial Enrollment PeriodTriggered by life events like moving or losing other coverage.
Dates are set by Medicare and apply nationwide. Confirm your personal windows at Medicare.gov or 1-800-MEDICARE.
Explore
When can you enroll? An interactive year
Enrollment windows are federal and the same nationwide. Confirm your personal dates at Medicare.gov or 1-800-MEDICARE.
Explore
The parts of Medicare
Good to know
Frequently asked questions
Q: I have Original Medicare and want to join a Medicare Advantage plan now. Can I use this window?
Q: If I switch plans in February, when does the new coverage begin?
Q: Do I have to tell my old plan I'm leaving?
- CMS — Medicare enrollment periods (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.