Here’s a bold truth: Medicare decisions can make or break your healthcare experience for an entire year. And this is the part most people miss—failing to act during open enrollment could leave you stuck with costly plans or limited care options. In my previous column, I broke down the critical choices you face when enrolling in Medicare or during the annual open enrollment period (October 15 to December 7, 2025). These decisions shape your coverage and costs for all of 2026, so there’s no room for error.
Today, let’s dive deeper into the process of selecting or switching Medicare Advantage plans—or even returning to Original Medicare. But here’s where it gets controversial: these changes can only be made during open enrollment or the first quarter of next year. Mess up now, and you could face steep expenses or restricted access to care. Worse, ignoring this window because everything seemed fine this year could backfire big time in 2026.
Original Medicare: The Costly Yet Flexible Option
If you’re on Original Medicare with a supplement, there’s typically little to do annually. This setup gives you access to nearly all providers who accept Medicare, and your supplement covers expenses wherever you live. It’s the gold standard—but it comes with a hefty price tag.
Every year, Original Medicare costs rise. For 2026, the monthly premium is expected to jump to $206.50 from $185 in 2025—an 11.6% increase, the largest in years. And this is the part most people miss: this hike will likely offset the projected 2.7% COLA increase in Social Security benefits. Plus, depending on your income, you might face the IRMAA surcharge, adding hundreds to your monthly bill. Details will be announced soon, so stay alert.
Your supplement costs will also climb, likely by 7% to 9%. While you can stick with your current plan, comparing options at Medicare.gov is wise. If costs soar, consider switching to a lower-cost plan with reduced coverage—assuming your health qualifies. All these rising costs add up, squeezing many seniors’ budgets. No wonder nearly half of Medicare beneficiaries opt for Advantage plans, which promise lower out-of-pocket costs—but at what price?
Switching Advantage Plans: The Hidden Pitfalls
For four years, I’ve highlighted the downsides of Advantage plans—essentially managed care. While they work well when you’re healthy, they often falter when you need specialized care, second opinions, or surgical referrals. Recent headlines have exposed delays and denials of services, and this year, the issues are worse. Many providers have dropped out of networks, frustrated by low reimbursements and red tape.
Here’s the kicker: you must review your Advantage plan now. The current open enrollment period and the Advantage-specific window in the first quarter are your only chances to switch plans or return to Original Medicare. Check your plan’s notice for changes in pricing, providers, and hospitals. If your doctor is no longer in-network, ask them which local Advantage plans they accept.
Start your search at Medicare.gov, where you can compare plans and provider directories. It’s tedious, and you can’t predict which specialists you might need next year. For free help, consult agents at eHealth.com or BoomerBenefits.com, or contact your State Health Insurance Assistance Program through ShipHelp.org. These services are funded by commissions built into plan costs.
Returning to Original Medicare: A Catch-22
Many people want to switch back to Original Medicare when they’re ill, seeking freedom to choose providers. You can do this during open enrollment, but here’s the catch: in most states, pre-existing conditions may prevent you from getting the most comprehensive supplement. You might have to settle for less coverage, trading freedom for higher out-of-pocket costs.
It’s frustrating that seniors must navigate this annual maze to ensure affordable, comprehensive coverage. But ignoring it isn’t an option. And this is the part most people miss: the process is unfair, but it’s unavoidable. That’s The Savage Truth.
Next week, we’ll tackle Part D drug plans—another must-review topic. Don’t miss it!
Thought-provoking question for you: Should Medicare reform prioritize simplifying plan choices, or is the current system fair enough? Share your thoughts in the comments—I’d love to hear your perspective!
