Medicare Advantage

How Worcester Residents Can Change Medicare Advantage Plans

For 2027, Worcester is looking at 50 Medicare Advantage plans: 9 new, 17 gone since 2026, and 24 still here but changed on premium, deductible, plan type or name, 4 of them under a new name. Below, how the lineup shifted in Worcester County and what to compare, with no plan ranked or recommended.

WORCESTER, Mass. — If you signed up for a Medicare Advantage plan last fall and now suspect it isn't the right fit, you still have time to change course. The Medicare Advantage Open Enrollment Period runs January 1 through March 31, and it gives current Advantage members a second look before the year locks in.

This window is easy to misunderstand, and using it the wrong way can leave you without the coverage you expected. Here is what it lets you do, what it does not, and how Worcester-area readers can get personal help before the March 31 deadline.

What the Open Enrollment Period actually is

The Medicare Advantage Open Enrollment Period (often shortened to MA OEP) is a three-month window when people already in a Medicare Advantage plan on January 1 can make one change. It is separate from the fall Annual Enrollment Period, which runs October 15 through December 7 and is open to everyone with Medicare.

Think of it as a limited do-over. If your January plan feels wrong — maybe a doctor is no longer in network, or your pharmacy coverage does not work the way you thought it would — this is your chance to adjust without waiting until next fall.

What you can change between Jan. 1 and March 31

During this window, you may:

• Switch from one Medicare Advantage plan to another Medicare Advantage plan.
• Drop your Medicare Advantage plan and go back to Original Medicare (Parts A and B).
• If you return to Original Medicare, add a stand-alone Part D prescription drug plan.

That's it. You get one change, and it takes effect the first day of the month after the new plan gets your enrollment.

What you cannot do in this window

The MA OEP is not a free-for-all. If you have Original Medicare on January 1 and want to join a Medicare Advantage plan for the first time this year, this window does not apply to you. You also cannot use it to join, switch, or drop a stand-alone Part D drug plan unless you are also leaving Medicare Advantage.

One more thing worth knowing: leaving Medicare Advantage for Original Medicare does not automatically guarantee you a Medigap (Medicare Supplement) policy. In many cases, insurers can use medical underwriting. Massachusetts has some of the more consumer-friendly Medigap rules in the country, but the specifics matter, and it is worth calling before you drop coverage.

Program facts to keep in mind for 2027

A few Medicare-wide numbers shape decisions this season:

• Part D has a new $2,100 out-of-pocket cap on covered prescription drugs in 2026.
• The Part D deductible cannot exceed $615 in 2026 ($700 in 2027).
• The old coverage gap, or "donut hole," is gone as of 2025 — Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across monthly payments rather than paying big bills at the pharmacy counter.
• Income-related monthly adjustment amounts (IRMAA) for Part B and Part D begin above $109,000 in income for a single filer in 2026.

None of these figures are plan-specific — they apply program-wide.

Local context for Worcester

Worcester sits in Worcester County, and Medicare Advantage plan availability is set at the county level. That means every Worcester resident chooses from the same menu of Advantage and Part D plans as neighbors across the county. When you compare options on Medicare.gov's Plan Finder, enter your ZIP code and the tool will show what is offered in your county.

Before making a change, gather a short list: your prescriptions and doses, your regular doctors and hospitals (including which UMass Memorial or Saint Vincent facilities you use), and any specialists you want to keep. That list is what makes a comparison meaningful.

How to avoid a costly mistake

• Do not disenroll first and shop later. Make the switch as one action so there is no gap.
• Check your drug list every year. Formularies change January 1, even if your plan name did not.
• Confirm your doctors take the new plan — not just the health system, the specific providers.
• Get free, unbiased help. In Massachusetts, the SHIP program is called SHINE (Serving Health Insurance Needs of Everyone). Counselors do not sell plans.