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Top 8 Reasons to Consider Switching Medicare Plans During AEP

Updated: Oct 28, 2021

It’s Annual Enrollment Period (AEP) season between October 15 and December 7. This is the time where all seniors can switch their Medicare coverage for the upcoming year. If you are not happy with your current coverage or the changes that are coming to your plan, or you are wondering if there is a better option available to you; this article is for you.

Top 8 Reasons to Consider Switching Medicare Plans During AEP


1. Poor customer service


It is reasonable to expect good customer service from your Medicare Advantage Plan. Poor customer service is one of the number one reasons that people choose to switch plans. Some things to consider:

  • When you call with a question, is there someone available to answer your call?

  • Do they send your Annual Notice of Change at the end of September or early October?

  • Is there a pattern of denying claims?

  • Are statements often inaccurate?

By 2023, customer experience could make up more than half of a plan’s star ratings which should make it easier to identify companies that are not doing a good job of supporting their members.


2. Your prescription drug costs went up


Prescription drugs are often expensive when they aren’t covered by insurance; that’s why most seniors depend on good prescription drug coverage to help cover the costs of their prescription drugs. If your plan has substantially increased the amount you will be paying for your prescription drugs, has dropped your prescription drug from their formulary, or your prescription drug needs are no longer suited to the current benefits, it is likely time to look for a new plan.


3. Your doctor is no longer “in-network”


Most plans require their members to seek “in-network” care from participating providers for the best possible coverage. If one or more of your trusted doctors is no longer “in-network” for your plan or you need to see a new specialist that isn’t in your plan’s network, now is the time to look for a plan that includes them.


4. Your plan expenses are too high


Whether the plan has increased its premium or other out-of-pocket expenses, your budget has changed, or you’ve been diagnosed with an illness that will require substantial out-of-pocket costs on your current plan, it may be time to look for an option that better meets your needs. The good news is that many plans are not increasing costs for 2022 and some costs are even declining.


5. Your financial status has changed


If you have experienced a drop in income or assets, you may now qualify for the Extra Help program for discounts on drug insurance premiums and copays. If you now qualify for Low-Income Subsidy, your Medicare agent can help you apply.


Conversely, an increase in income can lead to disqualification from Low-Income Subsidy, making an existing plan’s premium suddenly more expensive than others.


AEP is the time to sit down with a Medicare agent to assess your current financial picture and the right plan for your needs in 2022.


6. You moved to a new county


Many plans only cover specific counties so if you have moved, you should review your current plan options with a Medicare agent.


7. Your plan will no longer be offered


If you received a notification that your Medicare plan will not be offered in 2022, it’s time to take a look at your options. If you do not actively choose a new plan, you could be rolled into a plan of the provider’s choice that may not meet your needs or comes with substantially higher costs.


8. Your lifestyle changes


If you have decided to start spending a significant amount of time traveling or living in another place for part of the year, it’s important to find a nationwide plan that will provide health coverage wherever you are. Many seniors who travel a lot choose Original Medicare with a Medicare supplement plan and Medicare Part D Plan to offset the out-of-pocket costs. Others look for a Medicare Advantage Plan that offers a nationwide network of providers that meets their needs and budget.


While this is not a complete list of the reasons that seniors may wish to change Medicare plans, we hope it has been helpful to you as you consider your options for 2022.



Our independent insurance agents are dedicated to assisting people on Medicare and those who are ready to transition from employer coverage to personal retirement coverage. We help kupuna understand their benefits options and apply for additional coverage, as needed. Because we represent all the major Medicare Advantage and supplement plans in Hawaii, we are able to offer unbiased advice; all at no cost to our clients.


At PBC, our clients are our number one priority and we look forward to getting to know you and your needs. Call us today at (808) 738-4500 to see how we may be of assistance.

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