Can I still make changes to my Medicare coverage for 2025?

The Medicare open enrollment period for 2025 coverage concluded on December 7. So for many people, opportunities to make changes to 2025 coverage have ended.

But depending on the circumstances, some people still have other opportunities to enroll or make changes to their coverage:

Medicare Advantage Open Enrollment Period

Anyone who already has Medicare Advantage coverage — which accounts for more than half of all Medicare beneficiaries¹ — can make one plan change during the Medicare Advantage Open Enrollment Period. This window runs from Jan. 1 through Mar. 31.

A person with Medicare Advantage can use this window to switch to another Medicare Advantage plan or to switch to Original Medicare (and add a Part D prescription plan, although access to Medigap will depend on medical underwriting in most states if the person doesn’t have a Medigap special enrollment period). If a plan coverage change is made during the MAOEP, the new coverage will take effect the following month.

Medicare special enrollment periods

Medicare special enrollment periods are available due to various circumstances, with differing rules for Medicare Part B (and premium Part A) versus Medicare Advantage and Medicare Part D.

If you experience one of the qualifying life events that triggers a special enrollment period, you may be able to enroll in Medicare without a late enrollment penalty and without having to wait until the next General Enrollment Period. Or if you already have private Medicare coverage, you may find that you have an opportunity to make a plan change due to the qualifying event.

If you’re unsure of your eligibility for a special enrollment period, you can call 1-800-MEDICARE to discuss the issue with a Medicare representative.

What is the 5-star special enrollment period?

If there’s a Medicare Advantage or Medicare Part D plan in your area that has earned the government’s 5-star (excellent) rating, you’re allowed to switch onto that plan anytime between December 8 and November 30. This is called the 5-star special enrollment period, and you’re allowed to utilize it one time during that period.

For 2025, only 11 Medicare contracts nationwide earned a 5-star rating (down from 36 in 2024). Two are Medicare cost plans, seven are Medicare Advantage plans with Part D coverage, and two are stand-alone Part D plans (see Tables A1, A2, and A3 here for details about the plans that received 5-star ratings for 2025).². So most enrollees do not have access to a 5-star plan in 2025, and thus cannot use the 5-star special enrollment period.

When can I enroll in a Medicare Special Needs Plan?

If you develop a condition that makes you eligible for a Medicare Special Needs Plan (SNP) and an applicable SNP is available in your area, you can join it at any time. Once you join, your special enrollment period ends.

If I am a dual eligible, when can I make changes to my Medicare coverage?

If you’re covered by both Medicare and Medicaid, you can switch plans up to once per quarter during the first three quarters of the year, and you also have access to the regular Open Enrollment Period in the fourth quarter of the year.³ This applies to Medicare Advantage as well as Medicare Part D.

Note that there are SNPs designed for people who are dual-eligible for Medicaid and Medicare, and there are also SNPs for people who are institutionalized.

When can I enroll in a Medigap plan?

You can apply for a Medicare supplemental insurance (Medigap) plan at any time during the year. If you’re within the six-month open enrollment window that begins as soon as you’re at least 65 and enrolled in Medicare Part B, the coverage is guaranteed issue. That is also the case if you’re in a special enrollment period triggered by a qualifying event. (Be aware that not all of the special enrollment periods for Medicare Advantage or Medicare Part D apply to Medigap plans).

You can still apply for a Medigap plan outside of open/special enrollment periods; just be aware that in most states, the carrier will use medical underwriting to determine whether to accept your application, and how much to charge you.

Some states have created annual windows during which enrollees can switch to a different Medigap plan without medical underwriting, but this is the exception rather than the rule; federal law does not grant any sort of annual open enrollment period for Medigap plans (you can click on your state on this map to see how Medigap plans are regulated).

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.

Footnotes

”August 2024, Medicare Monthly Enrollment” Centers for Medicare & Medicaid Services. Accessed Dec. 9, 2024 ⤶
”2025 Medicare Advantage and Part D Star Ratings” Centers for Medicare and Medicaid Services. October 10, 2024 ⤶
”Special Enrollment Periods; Other Special Situations” Medicare.gov. Accessed July 10, 2024 ⤶

Tags: disenrollment, dual-eligibility, five-star rating, Medicare Part C, Medicare Part D, plan changes, special enrollment period

2025 coverage: Medicare enrollment dates at a glance

Beyond your initial opportunity to enroll in Medicare plans, the federal government provides other windows for enrollment and plan changes each year.

What is the MAOEP?

During the MAOEP, Medicare Advantage enrollees can switch to Original Medicare or to a different Medicare Advantage plan from the one they are currently enrolled in.

What are Medicare star ratings?

CMS uses a star rating system to evaluate Medicare Advantage plans and Medicare Part D plans.

Can I be enrolled in Medicare and Medicaid at the same time?

Some Americans qualify for both Medicare and Medicaid, and when this happens, it usually means they don’t have any out-of-pocket healthcare costs.