Medicare Advantage

Central Falls Medicare Advantage: AEP for 2027

People in Central Falls can choose from 22 Medicare Advantage plans for 2027, against 23 this year. One of this year’s plans are gone, 0 are new to Providence County, and 12 that continue have changed their premium, deductible, plan type or name, 4 of them under a new name.

Central Falls, R.I. — For Medicare beneficiaries here, the calendar has turned to the season when coverage choices for next year are made. The Annual Enrollment Period runs October 15 through December 7, 2026, and it gives people on Medicare a clean chance to join, switch, or drop a Medicare Advantage or Part D plan for coverage that starts January 1, 2027.

This fall window has specific rules about what you can and can't do. Here's what Central Falls residents should know before the December 7 deadline.

Who this window is for

The Medicare Advantage Open Enrollment Period, sometimes called MA OEP, is only for people who are already enrolled in a Medicare Advantage plan as of January 1. If you're on Original Medicare (Part A and Part B) and don't have an Advantage plan, this period is not for you — you'd generally need to wait until the fall Annual Enrollment Period (October 15 – December 7) or qualify for a Special Enrollment Period.

If your current Advantage or Part D plan isn't fitting the way you hoped, or if your plan's Annual Notice of Change (ANOC) shows terms you don't like for 2027, this is your yearly window to make a change.

What you can change between January 1 and March 31

There are two moves allowed during MA OEP:

1. Switch to a different Medicare Advantage plan. That includes moving between an HMO and a PPO, or moving to a plan with or without drug coverage. 2. Leave Medicare Advantage and go back to Original Medicare. If you make this switch, you can also join a stand-alone Medicare Part D prescription drug plan at the same time.

You can only make one change during this window. Once it takes effect, you're locked in until the next Annual Enrollment Period unless a Special Enrollment Period applies (for example, if you move out of your plan's service area).

What you cannot do during this window

It's just as important to know the limits:

• You can't switch from Original Medicare to a Medicare Advantage plan.
• You can't join a stand-alone Part D plan if you're staying on Original Medicare and weren't in an Advantage plan on January 1.
• You can't use this period to buy or change a Medigap (Medicare Supplement) policy on a guaranteed-issue basis in most cases — Medigap has its own rules, and medical underwriting may apply depending on your situation and Rhode Island's state protections. Call your SHIP before you assume anything here.

The 2027 numbers worth keeping in mind

Whether you stay put or switch, a few program-wide figures shape what your drug coverage will look like next year:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once your out-of-pocket spending on covered drugs hits that amount, you pay nothing for covered Part D drugs the rest of the year.
• Part D maximum deductible: $615 in 2026 and $700 in 2027. Plans can charge less, but not more.
• No more coverage gap: The old "donut hole" was eliminated in 2025. Part D now has three phases — deductible, initial coverage, and catastrophic.
• Medicare Prescription Payment Plan: An optional program that lets you spread your yearly drug costs across monthly payments instead of paying big amounts at the pharmacy counter.
• IRMAA: Higher-income beneficiaries pay Part B and Part D surcharges. For 2026, IRMAA starts above $109,000 in income for a single filer (based on your 2024 tax return).

Central Falls and Providence County

Central Falls is in Providence County, where Medicare Advantage plan choices are set at the county level. That means when you shop on medicare.gov, the plans you see are the ones offered to Providence County residents — not just Central Falls specifically. For 2027, Providence County has 18 Medicare Advantage plans from 4 carriers, compared with 23 plans from 4 carriers in 2026; 18 plans continue, 1 is not returning, and 4 have been renamed, while 8 continuing plans change something in their terms (your ANOC has the details). It's worth running a fresh comparison rather than assuming last year's options still apply.

How to make a smart change (not a rushed one)

Before you switch or drop a plan:

• Check the drug list (formulary). Confirm your current prescriptions are covered and note the tier.
• Check the provider network. Make sure your primary care doctor, specialists, and preferred hospitals are in-network.
• Look at the total picture. Premiums, deductibles, copays, out-of-pocket maximums, and referral rules all matter — not just one line item.
• Get a second set of eyes. Rhode Island's SHIP (State Health Insurance Assistance Program), called POINT — Rhode Island's SHIP for older adults — offers free, unbiased counseling.