Medicare Advantage

Brattleboro Medicare Advantage members get one change Jan 1–Mar 31

BRATTLEBORO, Vt. — If you signed up for a Medicare Advantage plan last fall and it isn't fitting the way you hoped, you get a second chance starting January 1. From January 1 through March 31, the Medicare Advantage Open Enrollment Period gives current Advantage members a window to make one change — no special reason required.

Here's what that means in plain terms, and how to think it through before the March 31 deadline.

What the Medicare Advantage Open Enrollment Period actually is

The Medicare Advantage Open Enrollment Period (often shortened to MA-OEP) runs every year from January 1 through March 31. It's separate from the fall Annual Enrollment Period that ended December 7.

This window is only for people who are already enrolled in a Medicare Advantage plan on January 1. If you're in Original Medicare, this particular window isn't for you.

You can make one change during MA-OEP, and it takes effect the first of the following month.

What you can do — and what you can't

During January 1 – March 31, if you're already in a Medicare Advantage plan, you may:

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

What you cannot do in this window:

• Switch from Original Medicare into a Medicare Advantage plan for the first time.
• Join a stand-alone Part D plan if you're staying on Medicare Advantage.
• Make a second change — once you use your one switch, that's it until fall.

One important note if you're thinking of returning to Original Medicare: a Medigap (Medicare Supplement) policy may require medical underwriting outside your original guaranteed-issue window. That's worth checking before you drop your Advantage plan.

Why this window exists

The fall Annual Enrollment Period is fast-moving, and plans change every year — provider networks shift, drug formularies get updated, and prior-authorization rules can look different in January than they did in the brochure. MA-OEP is essentially a built-in "does this actually work for me?" review period.

Common reasons people use it:

• A preferred doctor or hospital is no longer in the plan's network in 2027.
• A regular prescription is no longer covered, or moved to a higher tier.
• Referral or prior-authorization rules are stricter than expected.
• The plan type (HMO vs. PPO) isn't a good match for how you actually use care.

A few numbers worth knowing before you switch

Whether you stay put or make a change, these program-level figures affect the math:

• Part D out-of-pocket cap: $2,100 for 2026 and $2,400 in 2027. Once you hit that in covered drug costs, you're done paying for covered drugs for the rest of the year.
• Part D maximum deductible: $615 in 2026 and $700 in 2027 (plans can set theirs lower).
• The old coverage gap ("donut hole") is gone as of 2025. Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the calendar year in monthly installments instead of paying big amounts at the pharmacy counter.
• IRMAA — the higher-income surcharge on Part B and Part D — begins above $109,000 in income for a single filer in 2026.

How to decide, without rushing

Brattleboro is in Windham County, where the county-level plan menu determines what's available to you. Before making a change:

1. Pull out your Annual Notice of Change (ANOC) from your current plan. It spells out what's different in 2027. 2. List your doctors and your prescriptions. Then check whether they're still in-network and on the formulary for any plan you're considering. 3. Use the Plan Finder at Medicare.gov. It lets you compare plans in Windham County side by side using your actual drug list. 4. Call your local SHIP. In Vermont, the State Health Insurance Assistance Program offers free, unbiased one-on-one counseling. They don't sell anything. 5. Don't wait until late March. Doctor's offices and pharmacies get busy verifying new coverage in April; giving yourself time helps avoid gaps.