Medicare Myth Buster: Will I Be Penalized for Changing Plans?

Ken Parson

Every year, as the Medicare Annual Enrollment Period (AEP) rolls around, myths start flying and one of the most common is the idea that changing your Medicare plan will lead to penalties. It's a fear that causes many beneficiaries to stick with plans that no longer meet their needs. At Triangle Medicare Solutions, we’re here to clear things up so you can make informed, confident choices.

 

Why Medicare Myths Stick Around

Medicare is complex, and even long-time enrollees can feel overwhelmed by the rules, deadlines, and fine print. This confusion gives way to myths, especially around penalties that spread quickly through word-of-mouth, online forums, and even well-meaning friends or family. But misinformation can keep you from making beneficial changes to your healthcare coverage, particularly during important times like AEP.

 

What Triggers a Real Medicare Penalty?

Let’s set the record straight: you will NOT be penalized for switching plans during the appropriate enrollment windows.

 

The penalties that do exist in Medicare are tied to late enrollment, not plan changes. Specifically:

  • Part B Late Enrollment Penalty applies if you delay enrolling in Medicare Part B and don’t have other credible coverage.

  • Part D Late Enrollment Penalty occurs if you go 63 or more consecutive days without prescription drug coverage after becoming eligible.

Changing from one Medicare Advantage plan to another, or switching Part D prescription drug plans, within the right window is perfectly acceptable and penalty-free.

 

When You Can Make Changes Without Penalty

Understanding Medicare’s enrollment periods can help you avoid both penalties and coverage gaps:

  • Annual Enrollment Period (AEP): October 15 – December 7
    This is the main window when all Medicare beneficiaries can switch Medicare Advantage (Part C) or Part D plans.

  • Medicare Advantage Open Enrollment: January 1– March 31
    If you’re already enrolled in a Medicare Advantage plan, you can make a one-time switch to another plan or return to Original Medicare.

  • Special Enrollment Periods (SEPs):
    These are triggered by certain life events like moving, losing employer coverage, or qualifying for Medicaid. SEPs allow you to make changes outside of AEP without penalties.

Let’s Bust Some Common Medicare Plan Change Myths

Here are a few persistent myths we often hear:

  • “I’ll be penalized if I change my plan.”
    Not true, as long as you switch during the correct enrollment window, there are no penalties.

  • “My coverage will lapse if I switch.”
    If you enroll in a new plan within the allowed timeframe, your new coverage starts automatically when your old plan ends, no gap.

  • “I can’t switch back to Original Medicare.”
    You can, and during certain periods (like the Medicare Advantage Open Enrollment), you can also add a Part D plan. In some cases, you may need to go through medical underwriting for a Medigap policy, but switching back is definitely allowed.

What Really Happens When You Change Plans

Changing your Medicare plan is typically a smooth process. Once enrolled in a new plan:

  • You’ll receive a new ID card in the mail.

  • Your provider network may change, so you’ll want to verify your doctors are still in-network.

  • Your prescription coverage could change, so it’s smart to check the new formulary.

  • Your new coverage begins automatically on the effective date, usually January 1 if changed during AEP.

Before switching, review your plan options carefully, consider costs, coverage, networks, and drug lists. That’s where local support can make a big difference.

 

North Carolina’s Trusted Medicare Resource

At Triangle Medicare Solutions, we take pride in being a local, education-first resource for Medicare beneficiaries in North Carolina. We don’t just sell plans, we help you understand them. Our goal is to make Medicare simple, so you can feel confident in your choices.

 

Whether you're considering a plan change, confused about enrollment windows, or just want to make sure you avoid penalties, we offer free, personalized support to guide you every step of the way.

 

Don’t let Medicare myths hold you back. If your current plan isn’t working for you, now is the time to make a change with confidence and no penalties. Contact Triangle Medicare Solutions today to get expert guidance and compare your options.