Top 5 Reasons Why People Choose to Switch Medicare Plans

Did you know that you don’t have to stay with your chosen Medicare plan? People enrolled in Original Medicare or private Medicare Advantage plans have the option to change plans. The timing of when someone can change their plan is dependent upon their unique situation. 

To learn more about when you can change Medicare plans read our blog or watch our video that explains the different enrollment periods. In this blog, we’ll focus on the Annual Open Enrollment Period (AEP) that runs each year from October 15 through December 7.

Medicare Benefits Solutions

May 26, 2022

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Who Can Switch Plans?

Who can switch, drop, or change Medicare plans during AEP:

  • Anyone enrolled in Original Medicare can join, switch, or drop a Part D prescription drug coverage plan
  • Anyone enrolled in Original Medicare can switch to a Medicare Advantage plan
  • Anyone enrolled in Medicare Advantage can switch to a different Medicare Advantage plan
  • Anyone enrolled in a Medicare Advantage plan can switch back to Original Medicare
  • And when it comes to MediGap, anyone can join, switch, or drop a Medicare Supplement plan during AEP

A Kaiser Family Foundation (KFF) study reported that 7 out of 10 Medicare beneficiaries don’t compare options for coverage during the annual enrollment period. Not comparing plans on a regular basis could mean you’re missing out on things like lower premiums or better coverage options.

AEP gives plan enrollees the opportunity to shop for a new Medicare plan based on their specific healthcare needs. Saving money with lower deductibles or finding a new plan when your doctor is no longer in-network are just a few reasons why people change plans.

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Medicare Benefits Plan Finder Tool

We’ve built a handy tool to help people compare their current plan to other plans available in their zip code and decide if they want to make a switch. The Plan Finder tool was created by the product development and marketing team at Medicare Benefits Solutions.

We’ve provided our customers with an easy way to compare health insurance coverage options and prescription drug plans while shopping for the best Medicare plan.

  • During AEP 2021 (October 15, 2021 – December 7, 2021), our Plan Finder Tool recorded the top reasons why people were looking for a new Medicare plan.
  • During AEP 10,723 people engaged with our Plan Finder tool
  • Over 2,000 people said dental coverage was the primary reason they were looking to switch their 2022 Medicare plan
  • Other reasons ID’d in our plan data included monthly premium, max out of pocket expenses and vision coverage

Read on to discover the top 5 reasons why people choose to switch Medicare plans in 2022*.

Top 5 Reasons to Switch Plans*

Our Plan Finder tool discovered some interesting statistics. When asked about the single most important reason to switch plans, there were 5 that were ranked in order of importance by policyholders.

The most important reason mentioned for switching:

  • 25.2%: dental coverage
  • 21.96%: monthly premium
  • 16.72%: max out of pocket
  • 6.85%: drug coverage
  • 6.58%: drug copay

Let’s take a closer look at these top 5 reasons to switch Medicare plans. 

Dental coverage

Scheduling regular dental appointments are important to ensure you have healthy teeth and gums for life. This leaves many policyholders concerned about the limited dental benefits covered by Original Medicare. Unfortunately, unless considered medically necessary, Medicare won’t provide coverage for dental services.

25.2% of Plan Finder users say finding good dental coverage that includes annual exams and cleanings is the main reason why they switch plans.*

Switching to a Medicare Advantage plan with additional benefits may provide certain dental coverage. This can include preventive care such as routine teeth cleanings and x-rays along with discounts on dentures, crowns, fillings, and more. Use our Plan Finder tool to help you discover Medicare Advantage plans that include dental coverage.

Monthly premium

When reviewing your annual health insurance you’ll want to focus on monthly premiums. Review your carrier’s Annual Notice of Change for any changes occurring in the new year. If your Medicare or Medicare Advantage premiums are going up, it might be time to consider switching plans.

Our Plan Finder data shows that finding a plan with a lower monthly premium is the #2 reason to switch plans with 21.96% of people choosing this option.*

You can keep your current plan if you’re satisfied with your coverage. But, if your monthly premiums are going up, use our Plan Finder tool to help you find a new plan with lower costs. There are no penalties to switch coverage during AEP and enrolling in a plan with lower premiums can help save you money.

Max out of pocket

Out of pocket (OOP), costs refer to any Original Medicare healthcare expenses you have to cover before your benefits kick in. OOP expenses can include things like monthly premiums, deductibles, hospital stays, prescription drug coverage, supplemental insurance and any services not covered by Medicare. 

When it comes to switching coverage, 16.72% of Plan Finder users were looking for a plan that offered lower yearly maximum out-of-pocket costs.*

A Medicare Supplement policy may help cover certain Original Medicare costs such as:

  • Part A & Part B copays
  • Part A & Part B coinsurance
  • Part A & Part B deductibles
  • Excess costs for Part B

You could also consider switching to a Medicare Advantage plan. Once you meet the yearly max OOP limit, your MA plan will cover 100% of additional services. When shopping for a new plan, pay attention to the cost versus benefits ratio. Some MediGap and Medicare Advantage policies may offer additional benefits but you could end up paying a higher monthly premium.

Drug coverage

Original Medicare Part A & Part B don’t include benefits for prescription drugs. This leads many Original Medicare policyholders to add a stand-alone Part D prescription drug coverage to their plan. Just pay attention to the fact that stand-alone Rx plans have their own yearly out of pocket limits.

Every healthcare plan includes a formulary of covered generic and brand-name prescription drugs. Medications are placed into different classes or tiers and each tier has a different cost associated with it. And, if you need any of the drugs not listed in your plan’s formulary you will have to pay full price. 

6.85% of people using our tool want a plan that includes a comprehensive formulary covering all their generic and brand-name prescription medications.*

If you are enrolled in Medicare Advantage, look for a MA plan that includes coverage for all currently prescribed medications. When it comes to over-the-counter medications, Original Medicare doesn’t provide any benefits. However, you can shop around for a Medicare Advantage plan that includes an allowance for OTC meds. 

Drug copay

Brand-name prescription drugs are almost always higher than a similar generic medication. But, sometimes there isn’t a generic equivalent available. This could result in higher drug copayments. 

Among people using our Plan Finder tool, 6.58% were looking for a Part D Prescription Drug or Medicare Advantage plan with lower drug copays.*

The good thing is drug copays vary from plan to plan, so you should always shop around for the best coverage. Our Plan Finder may be able to help you find a Medicare Advantage or Part D Prescription medication coverage plan with lower drug copays. 

*Data collected during 2021 AEP from people using the Medicare Benefits Solutions Plan Finder Tool

Try Our Plan Finder Tool

A lot can change in a year. With Medicare and Medicare Advantage plans continually evolving you may find yourself looking for a new plan at some point. We recommend trying our new and improved Plan Finder to help you search for a plan that has more of what you want.

Our tool lets you compare your current plan to other plans available in your zip code side-by-side, find additional benefits, check if your prescription drugs are covered and more. Search for Medicare plans that include dental coverage, vision coverage, hearing coverage, lower drug copays, and max out of pocket expenses. 

Shop and Compare 2022 Plans With Our Medicare Plan Finder Tool


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