Medicare Advantage

Picked the Wrong Advantage Plan? You Have Until March 31

South Kingstown, R.I. — If the plan you locked in during fall enrollment isn't fitting the way you hoped, you have a second chance. From January 1 through March 31, the Medicare Advantage Open Enrollment Period gives people already enrolled in a Medicare Advantage plan one opportunity to make a change. It's a narrower window than the fall Annual Enrollment Period, and it comes with its own rules — but for South Kingstown residents who realized in January that a doctor isn't in network or a prescription isn't covered the way they expected, it can be a real relief.

Who this window is for

The Medicare Advantage Open Enrollment Period (often shortened to MA OEP) is designed for one group: people who are already enrolled in a Medicare Advantage plan on January 1. If you have Original Medicare — Part A and Part B — this window is not for you. And if you only have a stand-alone Part D drug plan, you can't use it to change that plan either.

That distinction trips up a lot of people. The fall Annual Enrollment Period (October 15–December 7) is open to everyone with Medicare. The January-through-March window is more limited on purpose.

What you can change between January 1 and March 31

If you qualify, here is what CMS allows during this period:

• Switch from your current Medicare Advantage plan to a different Medicare Advantage plan.
• Drop your Medicare Advantage plan and go back to Original Medicare.
• If you return to Original Medicare, you can also join a stand-alone Medicare Part D prescription drug plan.

You get one change during this window. Once you make it, the door closes until the next enrollment opportunity. The change takes effect on the first day of the month after the plan gets your enrollment request.

What you cannot do in this window

Just as important is what this period does not cover:

• You cannot use it to join a Medicare Advantage plan if you started the year on Original Medicare.
• You cannot switch from one stand-alone Part D drug plan to another stand-alone Part D plan.
• It is not a guaranteed-issue window for Medigap (Medicare Supplement) coverage. In many cases, moving from Advantage back to Original Medicare means Medigap insurers can use medical underwriting — so it's worth asking questions before you make the switch.

Why people use this period

The most common reasons a South Kingstown resident might act between January and March are practical ones. A prescription filled in January turns out to have a higher cost-sharing tier than expected. A preferred specialist at South County Health or a Providence-area hospital isn't in the new plan's network. The pharmacy that's easiest to get to isn't a preferred pharmacy. Or the plan simply doesn't feel like the right match once real appointments start happening.

None of that means you're stuck for the year. It just means you need to act before March 31.

2027 numbers worth knowing

A few program-level figures apply no matter which plan you're in:

• The Part D out-of-pocket cap is $2,100 in 2026. Once your out-of-pocket spending on covered drugs hits that number, you pay $0 for covered Part D drugs for the rest of the year.
• The Part D maximum deductible is $615 in 2026 (plans can set a lower one).
• The old "donut hole" coverage gap was eliminated in 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 payments instead of paying at the pharmacy counter. It's optional and free to opt into.
• IRMAA (the income-related surcharge on Part B and Part D premiums) starts above $109,000 in income for single filers in 2026.

How to make a change

Before you switch, gather your current medication list, your regular doctors, and your preferred pharmacy. Then:

• Visit medicare.gov and use the Plan Finder to compare options available in Washington County.
• Call 1-800-MEDICARE (1-800-633-4227), available 24 hours a day, seven days a week.
• Contact Rhode Island's State Health Insurance Assistance Program — locally known as THE POINT / SHIP — for free, unbiased one-on-one counseling. SHIP counselors don't sell plans and don't earn commissions.

South Kingstown is in Washington County, and Medicare Advantage and Part D plan availability is determined at the county level. That means when you shop, you're comparing the plans offered across the county, not only in the town itself.