CMS Has Options for People Still Looking for a 2026 Medicare Advantage Plan

Depending on your situation, you may still have opportunities to enroll in or switch Medicare Advantage plans through special or alternative enrollment periods.

What Is a Special Enrollment Period?

A Special Enrollment Period (SEP) is a time when you are allowed to change your Medicare plan coverage for certain events that happen in your life. These qualifying life events can happen throughout the year and may make you eligible to enroll in a 2026 plan between December 8-30. The time you have to make these changes depends on the type of event.

Here are some of the most common reasons you might qualify for an SEP:

You change where you live

• I moved to a new address that isn’t in my plan’s service area.

• I moved back to the U.S. after living outside the country.

You lose your current coverage

• My current Medicare Advantage or Part D plan has exited the market and is no longer available in my service area.

• I am no longer eligible for Medicaid.

• I left my coverage from my employer or union (including COBRA).

You have a chance to get other coverage

• I am enrolling in other creditable prescription drug coverage as good as Medicare drug coverage (like TRICARE or VA coverage).

Other special situations

• I have Medicare and Medicaid, or I get Extra Help paying for Medicare drug coverage.

• I found out that I won’t be eligible for Extra Help next year.

If you think you qualify for a “Special Enrollment Period” but aren’t sure, you can reach out to Clover to help you. Call us at 1-800-836-6890 (TTY 711), 8 am–8 pm, 7 days a week*.

What if you already enrolled in a Medicare Advantage plan for 2026? Can you switch? The answer is possibly during what is called the Medicare Open Enrollment Period.

What Is the Medicare Advantage Open Enrollment Period?

The Medicare Advantage Open Enrollment Period (MA OEP) runs from January 1 to March 31 each year. This period is different from the October 15 - December 7 enrollment period.

CMS designated the Medicare Advantage Open Enrollment period as the only time when people who are already on a Medicare Advantage plan can make a change during the year without a Special Enrollment Period. CMS gives you a chance to make a one-time change to your coverage for the remainder of the year. There are limitations.

What Are the Limitations of OEP?

If you have a Medicare Advantage plan, CMS allows you to:

• Switch to a different Medicare Advantage plan with or without drug coverage. 

• Drop your Medicare Advantage plan and go back to Original Medicare.

  • If you decide a Medicare Advantage plan isn't for you, you can use this period to switch back to your basic Original Medicare (Part A and Part B). If you choose to do this, you can also add a separate Medicare Prescription Drug plan (Part D) to help with your prescription costs. 

Remember, you can only make one change during this time. It's important to make sure your healthcare coverage is exactly what you need for the rest of the year.

In Summary

Even though the main enrollment time is over, you may still have options to get the healthcare coverage you need. Don't wait—find out what you can do today.

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