Medicare Advantage

Medicare Advantage changes in Burlington: Jan 1–Mar 31

BURLINGTON, Vt. — If you woke up in January with buyer's remorse about the Medicare Advantage plan you picked last fall, you are not stuck with it. The Medicare Advantage Open Enrollment Period runs January 1 through March 31, and it gives people already on an Advantage plan a limited chance to make one change before the year settles in.

Burlington seniors get a second window to adjust their coverage

This window is smaller and more specific than the Annual Enrollment Period that ended December 7. It is not a do-over for everyone — it is for people who are already in a Medicare Advantage plan on January 1 and want to rethink that choice.

What you can change between January 1 and March 31

During the Medicare Advantage Open Enrollment Period, you can:

• Switch to a different Medicare Advantage plan (with or without drug coverage).
• Drop your Medicare Advantage plan and return to Original Medicare (Parts A and B).
• Add a stand-alone Part D prescription drug plan if you go back to Original Medicare.

You are limited to one change during this window, and it takes effect the first day of the month after your new plan gets your request.

What you cannot do in this window

This period is narrower than many people expect. During January 1 – March 31, you cannot:

• Switch from Original Medicare to a Medicare Advantage plan.
• Join a stand-alone Part D plan if you are staying on Original Medicare without a recent Advantage plan.
• Make more than one change.

If you missed the Annual Enrollment Period (October 15 – December 7) and you are on Original Medicare, you generally have to wait — unless you qualify for a Special Enrollment Period because of a move, a loss of other coverage, or another qualifying life event.

Why Burlington residents may want to look again

Burlington sits in Chittenden County, where residents have a range of Medicare Advantage plans and stand-alone Part D plans to choose from. Availability, provider networks, and drug formularies are all set at the county level, so what is offered in Chittenden County may look different from what your friends in, say, Rutland or Franklin County see.

A few reasons people revisit their choice in January and February:

• The plan's provider network changed and a preferred doctor or the UVM Medical Center specialist you see is no longer in-network.
• A prescription you take is now on a different tier or is no longer covered.
• Referral or prior authorization rules feel more restrictive than expected.
• Your health needs changed over the winter.

Program-level changes to keep in mind for 2027

Even if you do not switch plans, a few Medicare rules are worth knowing as 2027 begins:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once you hit that amount in covered drug costs, you pay nothing for covered Part D drugs the rest of the year.
• Part D maximum deductible: $615 in 2026 ($700 in 2027).
• The coverage gap (“donut hole”) is gone. Part D now has three phases instead of four.
• Medicare Prescription Payment Plan: You can ask your Part D plan to spread your drug costs across the calendar year in monthly payments instead of paying big amounts at the pharmacy counter.
• IRMAA surcharges for higher-income enrollees begin above $109,000 in income for a single filer in 2026.

These are federal rules, so they apply the same way in Burlington as they do anywhere else.

How to make a change without making a mistake

Before you switch, do three things:

1. Check the provider directory for the plan you are considering. Call the doctor's office directly to confirm they still take that plan for 2027 — directories can lag. 2. Run your prescriptions through the plan's formulary on Medicare.gov's Plan Finder. Look at tier, quantity limits, and prior authorization. 3. Check your total yearly cost estimate, not just the premium. Deductibles and copays add up differently depending on how often you use care.