Should You Switch Medicare Plans in 2026?

Three weeks before the Annual Enrollment Period opens, the advertising starts. Mailers, television spots, and phone calls all deliver the same message: there is a better plan out there and you are missing it. Some of the time that is true. Often it is not, and switching for the wrong reason costs more than staying put.

The useful question is narrower than “is there something better.” It is whether anything about your coverage, your health, or your budget actually failed you this year, and whether a different plan would have handled it differently.

Elizabeth Bryson, the licensed Medicare specialist behind Elizabeth Bryson Insurance Group in Monument, runs this evaluation with Tri-Lakes clients every fall. Most years, somewhere between a third and a half of the people she reviews end up keeping what they have. The review is still worth doing, because the ones who should move usually do not know it until someone walks them through the math.

Start With What Went Wrong This Year

Before looking at a single alternative plan, write down what your current coverage cost you and where it created friction. Four questions do most of the work.

• What did you actually pay out of pocket in the last twelve months, counting premiums, copays, drug costs, and anything the plan denied?
• Did you ever delay or skip care because of what it would cost or how long approval took?
• Did any doctor, specialist, or facility you wanted to use turn out to be outside the network?
• Did a prescription get denied, moved to a higher tier, or require prior authorization that took weeks?

If all four answers are clean, you are looking for reasons to switch rather than responding to a real problem. That is a fine place to be, and it usually means a quick comparison and a decision to stay.

When Switching Usually Makes Sense

Certain situations point clearly toward a change, and most of them show up in the Annual Notice of Change that arrived in September.

A prescription moved tiers or came off the formulary

This is the most common legitimate reason to switch, and the most under-noticed. One maintenance medication moving from a flat copay tier to a coinsurance tier can add hundreds of dollars across a year. Drug plans differ from one another far more than they differ in premium, and matching the plan to your specific prescription list is the single highest-value comparison in Medicare.

A doctor or hospital left the network

Provider contracts are renegotiated annually. When a specialist you rely on in northern Colorado Springs drops out of your plan’s network, you have two options: change doctors or change plans. For a person mid-treatment, changing plans is often the less disruptive one.

Your maximum out-of-pocket rose sharply

The annual out-of-pocket maximum on a Medicare Advantage plan defines your worst possible year. When it climbs several thousand dollars, your exposure has changed even if you were healthy last year and paid almost nothing.

Your health changed

A new diagnosis, a planned surgery, or a new specialty medication changes which plan design fits. A plan built around low routine costs may be the wrong instrument for a year that involves a hospital stay and ongoing specialist care.

Your plan is leaving the area

If your plan is not being renewed in El Paso County, the decision is made for you. That notice also opens a Special Enrollment Period, which gives you more flexibility than the standard deadlines allow, including a path back to a Medicare Supplement policy with guaranteed-issue rights in some circumstances.

When Staying Put Is the Better Call

Just as many situations argue for leaving things alone, and they get far less airtime than the reasons to move.

If your plan’s changes for 2027 are small, your prescriptions are all still covered at the same tier, and every provider you use is still contracted, there is nothing to gain from a change and real disruption to risk. Switching plans means new cards, new prior authorizations, sometimes a new pharmacy relationship, and a deductible that starts over.

If you are in the middle of a course of treatment, continuity has value that is hard to price. Prior authorizations do not transfer between plans. A therapy approved under your current plan may need to be re-approved by a new one, and that process can take weeks.

If you have a Medicare Supplement policy and you are healthy enough that a different carrier would accept you, the only question is price for identical coverage, and that comparison can be made without touching your Advantage or drug coverage. If you are not healthy enough to pass underwriting, staying is not just the better call, it is the only safe one.

Compare Total Annual Cost, Not Premium

The premium is the number carriers advertise because it is the number people compare. It is also the least informative figure on the page.

Build a total instead. Twelve months of premium, plus the deductible you would realistically meet, plus your expected drug costs under that specific plan’s formulary and tier structure, plus copays for the visits you know you will have. Then note the maximum out-of-pocket as your ceiling for a bad year. Do that for your current plan and for each alternative, and the ranking often reverses.

Two people in the same Monument neighborhood, both on Medicare, can get opposite answers from the same two plans. The variable is almost never the premium. It is the drug list.

Leaving Medicare Advantage for Medigap Is Not Always Reversible

This is the part of the decision that carries the most risk, and it is the part the advertising never mentions.

Medicare Advantage plans must accept you regardless of health, with limited exceptions. Medicare Supplement policies, which pair with Original Medicare to cover most of the 20 percent that Part B leaves behind, do not work that way outside of protected windows. Your guaranteed right to buy any Medigap policy sold in Colorado without health questions is a six-month window that begins the month you turn 65 and are enrolled in Part B. Once it closes, it does not come back on an annual schedule.

Colorado does not have a state rule granting an annual guaranteed-issue period for Medigap switching. That means a person who chose a Medicare Advantage plan at 65, developed a chronic condition at 70, and now wants the freedom of Original Medicare plus a Supplement may apply and be declined.

Two federal protections are worth knowing. If you joined a Medicare Advantage plan when you first became eligible at 65, you have a trial right during the first twelve months to drop it and buy a Medigap policy with guaranteed issue. And if you dropped a Medigap policy to try Medicare Advantage for the first time, you generally have twelve months to return to a Medigap plan. Both are one-time protections with strict timing, usually 63 days from the qualifying event, and both are easy to lose by waiting.

Switching Part D by Itself

If you have Original Medicare with a standalone Part D drug plan, and possibly a Medicare Supplement alongside it, your decision is simpler and lower risk. Part D plans accept anyone eligible without health questions. You can change drug plans during the Annual Enrollment Period every year without affecting your Supplement, your doctors, or anything else.

That makes an annual Part D comparison close to free, and it is worth doing every single year. Drug plans reshuffle their formularies and tiers more aggressively than any other product in Medicare, and last year’s best fit is frequently not this year’s.

The Deadlines That Govern Your Decision

The Annual Enrollment Period runs October 15 through December 7, 2026. Anything you elect takes effect January 1, 2027. You may change your mind as many times as you like inside that window, and the last election on file is the one that stands.

Details on 2027 plans become available October 1, which gives two weeks to compare before the window opens. That is the right time to do the work, not the first week of December.

From January 1 through March 31, 2027, anyone already enrolled in a Medicare Advantage plan gets one additional change: switch to a different Advantage plan, or leave for Original Medicare and add a drug plan. That window does not create Medigap guaranteed-issue rights, which is why it is a weaker safety net than people assume.

Outside those windows, Special Enrollment Periods open for specific events, including moving out of your plan’s service area, losing employer or union coverage, qualifying for Extra Help or Medicaid, or your plan leaving your county.

Helping a Parent Decide Without Deciding For Them

Adult children often arrive at this question from the outside, having seen a bill or heard about a denied claim, and the instinct is to fix it by finding a better plan. That instinct is sound and the execution matters.

Gather three things before comparing anything: the current plan name and member ID exactly as printed on the card, a full prescription list with dosages from the pharmacy, and the names of the doctors and facilities your parent wants to keep. Without all three, any comparison is guesswork.

Then take the underwriting question seriously. If your parent is on a Medicare Advantage plan and their health has declined, the door back to a Medicare Supplement may already be closed, and finding that out through a declined application after cancelling coverage is the worst possible sequence. Ask a broker to check the path before anything is cancelled.

Keep the decision with your parent. What usually works is doing the legwork, laying out two or three real options with total annual costs, and letting them choose. Elizabeth Bryson regularly holds these reviews with a client in Monument and adult children joining by phone or Zoom from out of state, and she will put the numbers in writing so the family can talk it over without a broker in the room.

Get an Honest Answer Before December 7

The value of an independent broker in this decision is that she has no reason to prefer one answer. Elizabeth Bryson has spent more than 30 years in insurance and more than 20 years living in the Tri-Lakes area, and she opened Elizabeth Bryson Insurance Group as an independent agency in 2020 after leaving a captive carrier. She represents multiple companies, which means “stay where you are” is a recommendation she can make freely, and one she makes often.

Her guidance costs you nothing. Independent Medicare brokers are compensated by the insurance carriers, never by the people they advise, whether you switch plans or keep the one you have.

She works with clients across Monument, Palmer Lake, Black Forest, and northern Colorado Springs, in her office, by phone, or over Zoom.

Bring your Annual Notice of Change, your prescription list, and your doctors’ names, and you will have an answer well before the December 7 deadline.

Plan availability, costs, benefits, and provider networks vary by carrier and by county and are subject to annual change. Enrollment period rules described here reflect federal Medicare requirements as of September 2026.