Medicare Advantage
Changing Your Medicare Advantage Plan in Providence
For 2027, Providence is looking at 22 Medicare Advantage plans: 0 new, 1 gone since 2026, and 12 still here but changed on premium, deductible, plan type or name, 4 of them under a new name. Below, how the lineup shifted in Providence County and what to compare, with no plan ranked or recommended.
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PROVIDENCE, R.I. — If you signed up for a Medicare Advantage plan last fall and something about it isn't sitting right — the doctor you wanted isn't in network, a prescription costs more than you expected, or the plan just doesn't fit your life — you are not stuck with that choice until next year.
Key takeaways
- From January 1 through March 31, people already enrolled in a Medicare Advantage plan get one chance to switch during the Medicare Advantage Open Enrollment Period, which is narrower than the Annual Enrollment Period that ends December 7.
- If you're happy with your current plan, you don't need to do anything during this window.
- Plan options in Providence County are set at the ZIP code level, so it's worth checking Medicare.gov's Plan Finder instead of assuming last year's plan lineup is still available.
- Before switching, check your prescription list against the new plan's formulary, confirm your doctors and hospitals are in network by calling their billing office, and read the plan's Summary of Benefits, since CMS Star Ratings are only one data point to consider.
Providence retirees get a second chance to adjust their coverage
From January 1 through March 31, the Medicare Advantage Open Enrollment Period gives people already enrolled in a Medicare Advantage plan one shot to change course. It's a quieter enrollment window than the fall rush, but for Rhode Islanders who want a do-over, it can matter a lot.
What you can (and cannot) do between January and March
This window is narrower than the Annual Enrollment Period that ends December 7. According to CMS, during Medicare Advantage Open Enrollment you can:
- Switch from one Medicare Advantage plan to another Medicare Advantage plan.
- Drop your Medicare Advantage plan and return to Original Medicare (Parts A and B).
- Add a standalone Part D prescription drug plan if you go back to Original Medicare.
What you cannot do in this window:
- Switch from Original Medicare to a Medicare Advantage plan.
- Join a standalone Part D plan if you're staying in Original Medicare and didn't already leave an Advantage plan.
- Make more than one change. You get one switch, and it takes effect the first day of the following month.
If you're happy with the plan you picked in the fall, you don't need to do anything.
How many choices do people in Providence actually have?
Providence is in Providence County, where Medicare plan availability is set at the county level. Rhode Islanders here typically see a healthy slate of Medicare Advantage options from several national and regional carriers each year. The exact plan list and any mid-year notices your carrier sends will be specific to your ZIP code, so it's worth checking the Plan Finder at medicare.gov rather than assuming last year's lineup carries over.
What's different about 2027 that could affect your decision
A few program-level changes are worth understanding before you make a switch:
- Part D out-of-pocket cap: In 2026, what you pay out of pocket for covered prescription drugs is capped at $2,100 for the year. Once you hit that, you pay $0 for covered drugs the rest of the year.
- Part D deductible: The maximum deductible a Part D plan can charge in 2026 is $615.
- No more donut hole: As of 2025, the old coverage-gap phase is gone. Part D now has three phases instead of four.
- Medicare Prescription Payment Plan: You can choose to spread your yearly drug costs into level monthly payments instead of paying big amounts at the pharmacy counter. It doesn't lower your total — it smooths it out.
- IRMAA: Higher-income beneficiaries pay a surcharge on Part B and Part D premiums. For a single filer in 2026, IRMAA kicks in above $109,000 in income.
How to make a smart switch, not a rushed one
Before you change plans, take an hour and do three things:
1. Pull your prescription list. Include doses. Then check whether each drug is on the new plan's formulary and what tier it sits on. 2. Confirm your doctors and hospitals. Networks change every January. Call the provider's billing office and ask directly — don't rely only on the plan's online directory. 3. Read the plan's Summary of Benefits. Pay attention to prior authorization rules, referral requirements, and any out-of-network coverage.
Star Ratings, published by CMS, can give you a sense of how members rate a plan on customer service and care. They're one data point, not a verdict.
Where to get free, unbiased help in Rhode Island
You don't have to figure this out alone, and you don't have to talk to a salesperson to get answers.
- Medicare.gov — the official Plan Finder, enrollment periods, and rules.
- 1-800-MEDICARE (1-800-633-4227) — 24/7, free.
- SHIP (State Health Insurance Assistance Program): In Rhode Island, this is The POINT / SHIP through the Rhode Island Office of Healthy Aging. Counselors are trained volunteers who don't sell anything.
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 Providence County
(MA penetration in Providence 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.
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The parts of Medicare
Good to know
Frequently asked questions
I'm turning 65 in February. Does this window apply to me?
If I switch in February, when does the new plan start?
Can I switch back if I don't like my new plan?
- CMS — Medicare enrollment periods (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.