The Cost of Staying Put: Could a Different Medicare Plan Save You Money?

Sticking with your Medicare plan may seem like the easiest route. You spent a while researching your current plan, and it seems to work adequately for you, so why rock the boat? Although keeping your current plan may be right for you in the end, simply “staying put” without considering or reviewing your options can backfire and create issues if your plan costs or health needs change [1]. If you’re unsure about how to evaluate your current plan and decide whether you should switch, this blog post is for you. We’ll cover how to make an informed Medicare choice that supports both your health and your budget.

Why People Stick With Their Medicare Plan

There are many reasons why you may feel reluctant to switch to a new Medicare plan. There’s likely a sense of comfort that comes with knowing the ins and outs of your usual plan, and some fear that comes with an unfamiliar plan. Some common factors that play into people’s choice to stick with their current Medicare plan include:

Behavioral factors, like a fear of change or the overwhelm that can come with an overload of information, may play into your hesitation to switch plans. You may be avoiding anxiety about making a big decision, whether the avoidance is conscious or subconscious.
Common misconceptions, such as the false belief that Medicare plans don’t change over the years, could be holding you back from making an informed decision.
Lack of awareness about available plans may make you stick with your current one, even though it may no longer meet your current health needs.

No matter what your holdup is, you can work past it with perseverance, resources, and knowledge.Let’s explore why reviewing your plan each year can help ensure it continues to support your health and peace of mind.

Hidden Costs of Staying Put With the Same Plan

Although you may think that the Medicare plan you’ve been on for years will stay the same, there are often changes each year that go unnoticed unless you review them carefully during the enrollment period. It’s helpful to be aware of these potential changes so you can understand how they may affect your coverage and budget. Some of these changes may include:

Premium costs: Although premium costs don’t often drastically change, it is quite common for them to increase a bit over the years. For example, Medicare Part B beneficiaries paid $174.70 in monthly premiums in 2024, but this increased to $180 in 2025 [2]. This difference may seem minuscule to some, but for others, it could be a dealbreaker.
Prescription drug formulary changes: A formulary is a list of prescription drugs covered by a health plan [3]. It’s essential to note that Medicare plans can modify their formularies at any time [4]. You will be notified of this change if it affects the medication you are taking, but it is something to consider when deciding whether to switch plans.
Provider networks or benefit changes: Your Medicare plan may change the healthcare providers it considers “in network” at any time [5]. This means that a doctor you’ve been seeing for years could suddenly not be covered by your insurance. Additionally, Medicare can make changes to benefits, like the initial coverage phase or coverage gap, which can affect how much you pay for your healthcare expenses [6].

When It Makes Sense to Reevaluate Your Medicare Coverage

If the previous factors have influenced your decision to consider switching Medicare plans, there is a right time to begin this process. You should review your plan options during the Annual Open Enrollment Period, which takes place October 15-December 7 [7]. The Annual Open Enrollment Period is the time you can join, switch, or drop Medicare plans, for which coverage will start January 1 [7].

Review your current plan versus other plans during this time (or a bit before, if you want to be extra prompt with changing enrollment). You’ll want to evaluate your health needs, like any emerging health conditions, new prescriptions, and preferred providers, before considering your options. This will help ensure you know exactly what you’re looking for in a plan based on your healthcare necessities.

Certain “qualifying life events” may prompt a Medicare review and open the possibility for a Special Enrollment Period, during which you can make changes to your plan even outside the Open Enrollment Period [8]. Some of these qualifying life events include loss of existing healthcare coverage, moving to a new location, changes in income, and changes in family structure (divorce, new child, etc) [8].

How to Compare Medicare Plans

When comparing plan options, you should consider the following factors:

Premiums: A premium is the cost you pay monthly to receive your Medicare plan benefits [9]. Premiums vary by plan and part, so consider these differences and your budget when comparing plans.
Deductibles: A deductible is the amount of money you pay annually for Medicare to start to pay for your healthcare services [10]. For example, if your deductible is $2,000, you’ll have to pay for your healthcare services until the cost reaches this amount. After it reaches this amount, Medicare will cover the majority of costs, and you’ll typically only have to pay a copayment or coinsurance. Just like premiums, deductibles also vary from plan to plan, so pay attention to this amount when comparing plans.
Copays: Copayments, or copays, are pre-determined costs of services that you must pay for Medicare to cover the rest [11].
Drug Coverage: Different Medicare plans may cover different lists of prescription drugs, at different costs. It’s helpful to check whether the plans you’re considering include your current prescriptions on their list of covered drugs
Network Size: Medicare plans also have varying healthcare providers considered “in-network” (meaning they are covered by the plan). You’ll want to assess whether the providers you want to continue seeing are in-network in any plan you consider.
Medigap vs Medicare Advantage: Many people get confused about the differences between these two plans, and why they can’t have both. Medigap is a supplemental insurance that helps cover out-of-pocket costs and requires that you are already enrolled in Medicare Part A and B [12]. On the other hand, a Medicare Advantage plan, also known as “Part C,” offers an alternative to Original Medicare and is offered by a private insurance company [13]. These plans bundle what is covered in Parts A, B, and D, plus some additional benefits.

For help navigating your comparison, use the Medicare “Compare Plans” tool.

Medicare Enrollment Without the Stress

If you have decided to enroll in a different Medicare plan, here’s a stress-free timeline to follow:

Mark your calendar for the Open Enrollment Period if you are switching Medicare plans. It’s helpful to enroll during this time to make sure your new coverage starts on schedule.If you are enrolling in a Medicare plan for the first time, ensure you are doing so during the Initial Enrollment Period to avoid late penalties and fees. The Initial Enrollment period starts 3 months before you turn 65 years old and ends 3 months after the month you turn 65 [14].
Work with a licensed Medicare agent for assistance. If you are ever confused about the enrollment process or want help comparing plans, licensed Medicare agents are available to help. Search for local Medicare brokers near you for assistance.
Compile a list of key questions you have before switching. Ensure you have the answer to all your questions before deciding to switch. You can either research the answers to the questions yourself or ask a broker.

Reviewing Your Medicare Plan Could Be the Smartest Financial Move You Make This Year

Taking the extra time to review your current Medicare plan concerning your healthcare needs can drastically alter your financial and health situation in the upcoming year. Make an annual review of your plan each enrollment period a yearly habit, just as important as paying your taxes or scheduling your annual physical exam. You should always feel confident in your Medicare decisions; for help getting to a place where you feel well-informed and content with your review, reach out for support today by contacting Greater Good Health.

The information shares is for educational purposes only and is not affiliated with or endorsed by the Medicare program. For more information, visit www.Medicare.gov.

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