Open Enrollment gives Lawrence residents a critical window to review and change their Medicare coverage. If your current plan no longer fits your needs, switching during this period can save you money and improve your healthcare access. Here’s exactly how to make the change.
When Can You Switch Medicare Plans?
Medicare’s Annual Enrollment Period runs from October 15 through December 7 each year. During these weeks, you can switch from Original Medicare to a Medicare Advantage plan, move between different Advantage plans, or change your Part D prescription drug coverage.
Your new coverage starts January 1 of the following year. Mark these dates on your calendar now so you don’t miss this annual opportunity to adjust your plan.
Lawrence residents also qualify for the Medicare Advantage Open Enrollment Period from January 1 to March 31. This gives you one chance to switch from your current Medicare Advantage plan to a different one or drop back to Original Medicare with a standalone Part D plan.
Step-by-Step Process to Switch Plans
Changing your Medicare coverage requires a clear approach. Let’s break it down.
Step 1: Review your current coverage
Pull out your most recent Summary of Benefits and look at what you actually used this year. Check your premium costs, copays for doctor visits, prescription drug expenses, and any out-of-pocket maximums you hit.
Step 2: Identify what’s not working
Did you struggle with high costs? Do you need specialists your current plan doesn’t cover well? Have your prescriptions changed? Write down your specific pain points.
Step 3: Research available plans
Visit Medicare.gov and use their Plan Finder tool. Enter your zip code (66044, 66046, 66047, or 66049 for Lawrence), your current prescriptions, and your preferred doctors. The tool shows all available plans in Douglas County ranked by estimated annual cost.
You can also explore Medicare Advantage plans available in Lawrence, KS to see comprehensive coverage options that bundle hospital, medical, and often prescription coverage.
Step 4: Compare your top options
Narrow your choices to three plans. Create a simple spreadsheet comparing monthly premiums, deductibles, maximum out-of-pocket limits, copays for common services, and prescription costs.
Step 5: Verify provider and pharmacy networks
This step prevents nasty surprises. Call your doctors’ offices directly and confirm they accept the new plan. Check that your preferred Lawrence pharmacies participate in the plan’s network.
Step 6: Enroll in your new plan
You can enroll three ways:
- Online at Medicare.gov (fastest method)
- By phone at 1-800-MEDICARE
- By contacting the insurance company directly
Step 7: Confirm your enrollment
The insurance company must send you a confirmation within 10 business days. Keep this document. Your old plan automatically terminates when your new coverage begins January 1.
For personalized help navigating your options, visit our guide on how to switch your Medicare plan in Lawrence, KS.
What to Compare Before Switching
Smart plan comparison goes beyond the monthly premium. Here’s what actually matters.
Total annual costs: Add your premium, deductible, and estimated copays for the year. A plan with a $0 premium might cost more overall if it has high copays for services you use frequently.
Provider network: A plan is worthless if your trusted Lawrence Medical Center physician isn’t in the network. Quality of care matters more than saving $20 per month.
Prescription drug coverage: Look at the plan’s formulary (drug list). Check which tier your medications fall into. A drug in Tier 1 costs far less than the same drug in Tier 3.
Extra benefits: Many Medicare Advantage plans include dental, vision, hearing, gym memberships, or meal delivery after hospital stays. Calculate the value of these additions based on what you’ll actually use.
Star ratings: Medicare rates plans from 1 to 5 stars based on quality and performance. Plans with 4 or 5 stars typically provide better customer service and health outcomes.
For details on when you can make these changes, check out Medicare Open Enrollment in Douglas County.
How to Check if Your Doctors Are in Network
Your relationship with your doctors matters. Don’t assume they’ll be in your new plan’s network.
Call the doctor’s office directly: Receptionists can tell you immediately which plans they accept. Ask specifically: “Do you accept [Plan Name] for Medicare Advantage?” or “Are you in-network for [Plan Name]?”
Use the plan’s online directory: Every Medicare Advantage plan maintains a searchable provider directory on their website. Search by doctor name or specialty. Print the results showing your doctor’s name.
Verify with the insurance company: Call the plan’s customer service number listed on their website. Ask them to confirm your doctor participates in their network. Get the representative’s name and reference number for your records.
Check if they’re accepting new patients: Being “in-network” doesn’t guarantee your doctor will accept you as a new patient under that plan. Ask this question explicitly.
Lawrence has excellent healthcare facilities, but network restrictions vary significantly between plans. LMH Health providers participate in different networks than KU Medical Center physicians.
How to Check if Your Drugs Are Covered
Prescription coverage can make or break a plan’s value for you.
Find the plan’s formulary: Every Part D and Medicare Advantage plan publishes their complete drug list online. Download this PDF or search their online formulary tool.
Look up each medication: Search for the exact name, dosage, and quantity your doctor prescribes. Generic and brand-name versions often fall into different tiers with different costs.
Note the tier and restrictions: Plans organize drugs into tiers (typically 1-5). Lower tiers cost less. Watch for:
- Prior authorization requirements (you need approval before filling)
- Quantity limits (maximum pills per month)
- Step therapy (you must try cheaper drugs first)
Calculate your actual costs: Multiply your monthly copay by 12. Don’t forget the deductible if the plan has one for prescription drugs.
Ask about alternatives: If your drug sits in an expensive tier, call your doctor. They might prescribe a therapeutically equivalent medication in a lower tier.
Many Lawrence pharmacies, including Hy-Vee, Walgreens, and Medicine Shoppe, participate in most networks. Confirm your preferred pharmacy works with your chosen plan.
Common Mistakes to Avoid When Switching
These errors cost Lawrence residents thousands of dollars each year. Here’s what to skip.
Focusing only on the premium: A $0 premium plan might seem attractive, but if it doesn’t cover your specialists or puts your medications in high tiers, you’ll pay more overall.
Ignoring the Annual Notice of Change: Your current plan mails this in September. It lists changes to coverage, costs, and networks for the coming year. Read it carefully before deciding to switch or stay.
Waiting until December: Plans can reach enrollment caps. Popular plans sometimes close to new members. Start your research in October, enroll by mid-November.
Forgetting to check pharmacy networks: Your medications might be covered, but if your pharmacy isn’t in-network, you’ll pay significantly more or need to switch pharmacies.
Not considering future health needs: You’re picking coverage for the entire year. If you’re planning surgery or know you’ll need new treatments, choose a plan that covers those services well.
Assuming Medigap works like Advantage: Medicare Supplement plans follow different rules. You can’t switch Medigap plans during Open Enrollment without medical underwriting (except in specific circumstances). Open Enrollment applies to Medicare Advantage and Part D plans.
Enrolling in multiple plans: You can only have one Medicare Advantage plan or one Part D plan at a time. Enrolling in a new plan automatically cancels your old one, but don’t create gaps by canceling before your new coverage starts.
Get Expert Help Switching Your Medicare Plan
Switching Medicare plans affects your healthcare for an entire year. The decision deserves careful attention and expertise.
Our licensed Medicare advisors serve Lawrence and Douglas County residents at no cost to you. We’ll compare every available plan based on your specific doctors, prescriptions, and budget. We handle the paperwork and confirm your enrollment completes correctly.
Contact us today for a free Medicare plan review. We’ll schedule a convenient time to meet in Lawrence, talk by phone, or connect via video call. Don’t navigate Open Enrollment alone when expert help is available at no charge.
Call now or visit our website to schedule your consultation. This year’s enrollment period ends December 7, and your future healthcare coverage depends on the choices you make right now.