Medicare Part D

Medicare Advantage second-chance window for Raleigh enrollees

RALEIGH, N.C. — Starting January 1, Medicare beneficiaries across the Triangle enter a three-month window that many people don't realize they have. The Medicare Advantage Open Enrollment Period runs January 1 through March 31, 2027, and it's a second chance to fix a plan choice that isn't working out.

If the plan you picked during the fall Annual Enrollment Period feels wrong — your doctor isn't in the network, a prescription isn't covered the way you expected, or the paperwork is confusing — you're not stuck with it until next year.

What this window actually is

The Medicare Advantage Open Enrollment Period (often shortened to MA-OEP) is different from the fall Annual Enrollment Period that just wrapped up on December 7.

The MA-OEP is narrower on purpose. According to Medicare.gov, it's only for people who are already enrolled in a Medicare Advantage plan on January 1. If that's you, you can use this window one time to make a change.

What you can do between January 1 and March 31

During the MA-OEP, you can:

• Switch from one Medicare Advantage plan to a different Medicare Advantage plan.
• Drop your Medicare Advantage plan and return to Original Medicare (Parts A and B).
• If you go back to Original Medicare, you can also join a stand-alone Part D prescription 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 more than one change. You get one move during this window.

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

Raleigh residents: check your county

Medicare Advantage plan availability is set at the county level, not the city level. Raleigh sits mostly in Wake County, where the menu of plans and carriers offered can differ from neighboring Durham, Johnston, or Franklin counties. If you live in Raleigh but your mailing address crosses a county line, that can affect the options you see.

The most reliable way to check what's actually available at your address is the Plan Finder tool at Medicare.gov, which pulls plans based on your ZIP code and county.

The 2027 numbers worth knowing

A few program-wide figures matter heading into next year, whether you stay put or switch:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once your out-of-pocket spending on covered prescriptions hits that ceiling, you pay nothing for covered drugs the rest of the year.
• Part D maximum deductible: $615 in 2026 and $700 in 2027 (plans can charge less).
• The coverage gap (“donut hole”) is gone. As of 2025, Part D has three phases instead of four. This carries into 2026.
• Medicare Prescription Payment Plan: an optional program that lets you spread your out-of-pocket drug costs across the calendar year in monthly payments instead of paying at the pharmacy counter. You have to opt in.
• IRMAA: higher-income beneficiaries pay an income-related surcharge on Part B and Part D. For 2026, the surcharge starts above $109,000 for a single filer (based on 2024 tax return income).

Common mistakes to avoid

Assuming your plan renewed exactly the same. Every fall, plans send an Annual Notice of Change (ANOC). Formularies, networks, and cost-sharing can shift year to year. If you didn't read yours, this window is the time to double-check.

Confusing this with the fall window. The Annual Enrollment Period (October 15 – December 7) is when almost anyone can make almost any change. The MA-OEP is more limited and only for people already on a Medicare Advantage plan.

Waiting until late March. Plan sales representatives get busy, and any change takes effect the following month. If you make a change on March 30, coverage doesn't shift until May 1.

Not checking whether your doctors are still in-network. Provider networks in Wake County can change mid-year. Call your doctor's billing office directly and ask.