Medicare Advantage

Medicare Advantage Open Enrollment in Greenwood, SC

GREENWOOD, S.C. — If you signed up for a Medicare Advantage plan last fall and now wish you had picked something different, you are not stuck. From January 1 through March 31, Medicare gives Advantage members a second look — a stretch called the Medicare Advantage Open Enrollment Period. It is short, it is specific, and it only comes around once a year.

Here is what Greenwood residents can and cannot do during this window, and where to get help from someone who does not sell plans.

What the January–March window actually is

The Medicare Advantage Open Enrollment Period, sometimes shortened to MA-OEP, runs each year from January 1 to March 31. It is separate from the fall Annual Enrollment Period (October 15 – December 7), which is when most people make their choices for the coming year.

The rules for MA-OEP are narrower than the fall window. It exists so people who are already enrolled in a Medicare Advantage plan on January 1 have a chance to correct course if the plan is not the right fit.

What you can change between January 1 and March 31

If you are enrolled in a Medicare Advantage plan on January 1, you can use this window to do one of the following:

• Switch to a different Medicare Advantage plan. You can move to another Advantage plan, with or without drug coverage.
• Drop your Medicare Advantage plan and return to Original Medicare (Parts A and B). If you do this, you can also add a stand-alone Part D drug plan.

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

What you cannot do during this window

MA-OEP is not a general do-over. According to CMS guidance on Medicare enrollment periods, during January 1 – March 31 you cannot:

• Switch from Original Medicare to a Medicare Advantage plan (if you were not already in one on January 1).
• Join a stand-alone Part D drug plan if you are staying on Original Medicare and did not have one already.
• Make more than one change. You get one switch during this window — choose carefully.

If you missed the fall Annual Enrollment Period and you are on Original Medicare, this window generally will not help you. You would usually need to wait until October 15 to make a fresh choice, unless you qualify for a Special Enrollment Period for reasons like moving or losing other coverage.

Why people in Greenwood use this window

Greenwood is in Greenwood County, where a range of Medicare Advantage plans is offered by several carriers. With that many options, it is common for someone to pick a plan in the fall and then, in January or February, discover something that does not work — a favorite doctor is not in the network, a prescription is handled differently than expected, or a specialist requires a referral they did not anticipate.

The MA-OEP exists for exactly that kind of situation. It is a chance to fix a mismatch, not a second shopping spree.

2026 and 2027 numbers worth knowing before you switch

Before you change plans, it helps to know the ground rules that apply to everyone on Medicare drug coverage. A few key figures are set at the federal level and apply nationwide:

• The Part D out-of-pocket cap is $2,100 for the year. Once your covered drug spending reaches that amount, you pay $0 for covered prescriptions the rest of the year.
• The maximum Part D deductible is $615. Plans can set a lower deductible, but not a higher one.
• The old coverage gap ("donut hole") is gone as of 2025. Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan is available if you would rather spread your drug costs across the year in monthly payments instead of paying at the pharmacy counter.
• IRMAA (the income-related surcharge on Part B and Part D premiums) starts above $109,000 in income for a single filer in 2026.

These figures come from CMS and apply nationwide — they are not tied to any particular plan.

How to make a switch you will not regret

A few steps that tend to save people headaches:

1. Check the drug list. Every Medicare Advantage plan with drug coverage has a formulary. Confirm each of your prescriptions is on it and see what tier it falls into. 2. Check the provider network. Call your doctors' offices directly and ask if they take the plan you are considering. Networks change during the year. 3. Consider the whole picture, not just the premium. Copays, referral rules, and how the plan handles specialists all matter. 4. Use unbiased help. In South Carolina, the State Health Insurance Assistance Program (SHIP) is called SC SHIINE. Their counselors do not sell insurance and their help is free.