Medicare Advantage

Medicare Advantage Open Enrollment: Your Jan. 1–March 31 Window

FAIRMONT, W.Va. — If you signed up for a Medicare Advantage plan during fall enrollment and are already having second thoughts, you're not stuck. The Medicare Advantage Open Enrollment Period (MA-OEP) runs January 1 through March 31, 2026, giving people already enrolled in a Medicare Advantage plan a second chance to make one change.

One shot to fix your Medicare Advantage choice — and it starts Jan. 1

This period isn't as widely advertised as the fall Annual Enrollment Period, but for Fairmont residents who realized their new plan doesn't cover a favorite doctor, includes an unexpected drug tier, or just isn't the right fit, it can be a lifeline.

Who can use this enrollment window

The MA-OEP is only for people who are already in a Medicare Advantage plan on January 1. If that's you, this window is open. If you're on Original Medicare (Parts A and B), the MA-OEP does not apply to you — you generally need to wait for fall Annual Enrollment (Oct. 15 – Dec. 7) unless you qualify for a Special Enrollment Period.

You can only use the MA-OEP once during the three-month window. Once you make a change, that's your move for the season.

What you CAN change between Jan. 1 and March 31

During the MA-OEP, you're allowed to:

• 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.

Any change you make takes effect the first day of the month after the plan receives your enrollment request.

What you CAN'T change during this window

The MA-OEP is narrower than fall enrollment. During January through March, you cannot:

• Switch from Original Medicare to a Medicare Advantage plan for the first time.
• Join or switch a stand-alone Part D plan if you're staying on Original Medicare (without a qualifying event).
• Change Medicare Supplement (Medigap) policies — those follow separate rules and medical underwriting may apply outside your initial Medigap window.

If any of these are what you need, you may have to wait until the next Annual Enrollment Period in the fall — or check whether you qualify for a Special Enrollment Period due to a move, loss of coverage, or other life change.

Fairmont is in Marion County — here's how availability works

Medicare plan choices are set at the county level, not the city level. Fairmont is in Marion County, so the Medicare Advantage and Part D plans available to you are the ones CMS has approved for Marion County residents.

To see the full list of what's offered locally, use the Plan Finder at medicare.gov and enter your ZIP code. That tool lets you compare plans side by side, check whether specific doctors and pharmacies are in network, and see how your prescriptions would be covered.

A few 2026 program facts worth knowing before you switch

Even if you're just tweaking your Medicare Advantage plan, these Part D rules now apply across the board:

• The Part D out-of-pocket cap is $2,100 in 2026. Once your covered drug costs hit that ceiling, you pay $0 for covered drugs the rest of the year.
• The Part D deductible cannot exceed $615 in 2026.
• The old coverage gap ("donut hole") is gone as of 2025 — Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs across the calendar year in monthly installments, instead of paying big amounts at the pharmacy counter. You have to opt in.
• IRMAA (the income-related premium surcharge) starts above $109,000 in income for a single filer in 2026.