I recently sat down with a client who said something I hear all the time: "My premium went up again, but I don't want to lose my doctor or my gym membership, so I'm just going to eat the cost." He assumed switching plans meant starting over. Losing the things he liked. That's not how it works.
Why This Year Feels Different (And Why It Should)
If it feels like your Medicare costs are climbing faster than usual, you're not imagining things. The standard Part B premium for 2026 jumped to $202.90 per month, up from $174.70 in 2024 and $202.90 in 2026. That's on top of whatever your Medigap or Advantage plan charges. When the baseline keeps rising, every extra dollar you're paying on a plan you haven't reviewed in a few years hits harder. That's the real reason to pay attention right now. The floor is going up, and if your plan's premiums are going up too, the gap between what you're paying and what you could be paying gets wider every year.
Why Smart People Overpay for Medicare
Here's the thing. Most people pick a Medicare plan once, set it, and never look at it again. That made sense for a year or two. But carriers adjust rates. New plans come to market. And the plan that was a perfect fit three years ago might now cost you $50 or $60 more per month than a nearly identical option from the same carrier.
That's real money. Over a year, that's $600 to $700. For a couple, you can double it. One pair of clients we worked with recently was overpaying by more than $2,000 a year, combined. They had no idea until they sat down with one of our advisors and ran the comparison.
When Can You Actually Make a Switch?
This is the question I get right after someone realizes they might be overpaying: "Can I do this right now, or do I have to wait until January?" The answer depends on what type of plan you're on.
If you're on a Medicare Advantage plan, your main window is the Annual Enrollment Period (AEP), which runs from October 15 through December 7 each year, with changes taking effect January 1. There's also the Medicare Advantage Open Enrollment Period from January 1 through March 31, where you can switch from one Advantage plan to another or drop Advantage and move to Original Medicare with a Medigap supplement.
If you're on a Medigap supplement, the rules are different and often more flexible. In many cases, you can apply for a new Medigap plan at any time during the year. There's no single open enrollment window the way Advantage works. The catch is that outside of your initial Medigap Open Enrollment Period (the six months starting when you're 65 and enrolled in Part B), you may have to go through medical underwriting. That means the insurance company can ask health questions and potentially decline your application. But if you're in good health, switching Medigap plans midyear is something we do with clients regularly.
There are also Special Enrollment Periods (SEPs) triggered by life events like losing employer coverage, moving to a new state, or qualifying for Extra Help. If something has changed in your life recently, you may have options you didn't know about.
Bottom line: don't assume you're locked in until next January. You might not be.
What Actually Happened (And What You Can Learn From It)
Let me walk through a few real scenarios from recent client meetings, with names changed of course.
One gentleman was on a Plan G Medigap supplement through Blue Cross. Solid plan. But his premiums had crept up over time. His advisor reviewed the options and found a different Medigap option through the same carrier, Blue Cross, that offered the same benefits he cared about (including his gym membership through SilverSneakers) for $58 less per month. Same carrier. Same network. Same doctors. Just a better fit for where he is right now.
Another couple came in because one spouse had just lost her job, which meant her employer health coverage was ending. She was overwhelmed. Her advisor walked her through three paths: staying on an employer plan through COBRA, going with a Medicare Advantage plan, or choosing a Medigap supplement. They compared costs, coverage, and doctor access side by side. She picked the option that kept her doctors and fit her budget. Because she was losing employer coverage, she qualified for a Special Enrollment Period, so she didn't have to wait for the fall to make her move.
And then there's the couple who were both on Medicare Advantage plans and kept getting hit with rate increases. They were skeptical about switching because they'd been told Advantage was "the best deal." Their advisor took the time to break down what they were actually paying (premiums, copays, out-of-pocket maximums) versus what a Medigap plan would cost. Once they saw the full picture, they switched. They kept their preferred doctors and saved over $2,000 annually between the two of them.
Don't Forget About Your Prescription Drug Coverage
One thing that catches people off guard when switching between Medicare Advantage and Medigap: your prescription drug coverage doesn't automatically follow you.
Most Medicare Advantage plans bundle Part D drug coverage into the plan. So if you leave Advantage and move to a Medigap supplement, you'll need to enroll in a separate standalone Part D plan to keep your prescription coverage. If you don't, you could end up with a gap in drug coverage and potentially face a late enrollment penalty that increases your Part D premium for as long as you have it.
Going the other direction, if you're on a Medigap plan with a standalone Part D plan and you switch to Medicare Advantage, your new plan will likely include drug coverage, so you'd drop the standalone Part D.
Either way, this is exactly the kind of detail that's easy to miss if you're doing it on your own. When we run comparisons for clients, we always factor in the prescription side of things, because saving $50 a month on your supplement doesn't help much if your drug costs go up by $75.
Three Things You Can Do This Week
You don't have to wait for open enrollment to start asking questions. Here's where to begin:
- Pull out your current plan summary. Look at your monthly premium, your out-of-pocket max, and your copays for doctor visits and prescriptions. Write them down.
- Use Medicare's own plan comparison tool at medicare.gov/plan-compare to see what's available in your zip code. You might be surprised.
- Call someone who can run a side-by-side comparison for you. Not a 1-800 number. A real person who knows your area, your doctors, and your prescriptions.
If you want to understand the basics before that conversation, my book Medicare Made 123Easy (on Amazon) covers all of this in plain English. I wrote it specifically for people who are too busy to wade through government pamphlets but too smart to just guess.
We're Here If You Want a Second Look
If your premiums have gone up and you've been putting off a review because you're worried about losing your doctors or your benefits, that's exactly the kind of thing we sort out every day. Give us a call. There's no cost to you, no pressure, no pitch. Just a conversation to see if there's a better option sitting right in front of you.
Easy Eddie's Take
- Don't just shrug and pay the increase. Check your plan summary, compare your copays, and make sure your doctors are still in-network.
- A quick review can save a couple thousand dollars a year.
- If you're on Medigap, you may be able to switch plans any time of year (not just during fall enrollment).
- If you're thinking about moving from Advantage to Medigap or the other way around, make sure you account for your Part D prescription drug coverage so nothing falls through the cracks.
- Go to medicare.gov/plan-compare and type in your zip code. You can see every plan available to you right now. And if the screen makes your eyes glaze over, that's what we're here for. Give us a call.