Author: Perry L Johnson

Recent data on Medicare Advantage plan switching highlights some important trends for those navigating their coverage options. Between 2016 and 2022, voluntary switching within Medicare Advantage plans increased significantly, especially among dual-eligible enrollees—those qualifying for both Medicare and Medicaid. For fully dual-eligible individuals, the switch rate rose from about 12% to 22%, and for partial dual-eligibles, from roughly 17% to 30%. Other beneficiaries also saw a smaller uptick, moving from about 10% to 13%. In contrast, few individuals moved back from Medicare Advantage to traditional Medicare by 2022: just 4% of fully dual-eligible, 2% of partial dual-eligible, and less than 1% of other beneficiaries made that switch.

It’s noteworthy that switching rates varied by age, risk, and racial or ethnic background. Older beneficiaries tended to stay put, while those with higher health risks were more likely to return to traditional Medicare. Even among these changes, those enrolled in dual special needs plans were less likely to switch. For many of my clients—whether individuals, families, or business owners—these shifts can mean adjustments in provider networks and plan features. As someone who’s spent years guiding people through the complexities of Medicare, I believe understanding these patterns is essential for making informed choices that align with long-term financial and health security.

I've noticed a notable trend when helping clients navigate their Medicare options: from 2016 to 2022, voluntary switching within Medicare Advantage plans increased sharply—especially among dual-eligible enrollees. Fully dual-eligible beneficiaries saw switching rates rise from about 12% to 22%, while partial dual-eligible rates climbed from approximately 17% to 30%. Other beneficiaries experienced a more modest change, from 10% to 13%. Interestingly, by 2022, moves from Medicare Advantage back to traditional Medicare remained uncommon—about 4% for fully dual-eligible, 2% for partial dual-eligible, and less than 1% for others. The data also shows that age, risk level, and race or ethnicity play a role: older beneficiaries tend to switch plans less often, while those at higher risk are more likely to opt for traditional Medicare. For those enrolled in dual special needs plans, switching was even less frequent. As someone who has spent decades helping clients protect their assets and plan for long-term security, I see how important it is to understand not just the numbers, but how these shifts could affect access to providers and plan benefits. Thoughtful Medicare planning can make all the difference in ensuring your coverage truly fits your needs—today and over time.

Many people are surprised to learn that while life insurance death benefits are typically tax free, the interest that accrues if you leave those proceeds with the insurer can become taxable—and that small detail can have a ripple effect on your Medicare costs. For example, if a widow with an average modified adjusted gross income (MAGI) of around $105,000 receives $10,000 in taxable interest from delayed life insurance payouts, she might cross the $109,000 single filer threshold for standard Medicare Part B premiums. At a MAGI of about $115,000, a single filer could see their Part B premiums increase by $81.20 per month and Part D by $14.50, totaling roughly $1,100 in extra annual premiums.

As someone who helps clients navigate the intersections of life insurance, health care, and tax planning, I often advise reviewing the timing of any interest payments from life insurance—especially if you’re close to a premium surcharge threshold. Additionally, if a spouse’s passing has significantly reduced your household income, you may be able to appeal for lower Medicare premiums by having the agency review your more recent income figures.

Before choosing to keep proceeds with an insurer, take time to understand how interest will be paid out, estimate your income in relation to these thresholds, and consider whether taking the funds sooner could help you avoid unnecessary taxable earnings. Personalized planning can help protect your assets and keep your Medicare costs manageable.

Some important news for those navigating Medicare Advantage: a major insurer recently announced plans to exit some Medicare Advantage markets in 2027, impacting around 600,000 members. For anyone affected, it’s crucial to remember that your Medicare eligibility remains intact—even if your particular Advantage plan isn’t renewed. Unless you actively choose a new plan, you’ll default back to Original Medicare.

The main enrollment period for making changes typically opens early in the fourth quarter and runs through mid-Q4, with most new coverage taking effect early in the new year. There’s also a special enrollment window that extends through mid-Q1, offering additional flexibility.

If you’re considering a shift back to Original Medicare, you may be eligible for a protected Medigap enrollment period—this window starts 60 days before your current coverage ends and lasts up to 63 days after. This can be a vital opportunity for securing supplemental coverage without medical underwriting.

Choosing the right path means looking beyond just premiums. Take time to compare doctors, hospitals, prescription formularies, copays, deductibles, and your maximum annual out-of-pocket costs. Sometimes, a $0 premium plan can come with significant tradeoffs elsewhere.

As someone who’s spent decades helping clients navigate Medicare options and long-term health security, I always recommend taking advantage of free, unbiased counseling through your state’s assistance program. And it’s wise to confirm your choices with Medicare or a trusted adviser to avoid any gaps in coverage. Thoughtful planning now can help protect your health—and your peace of mind—down the road.

As someone who guides clients through the complexities of Medicare planning, I want to highlight some key steps if your Medicare Advantage Prescription Drug (MA-PD) plan is set to end. If no replacement is selected, Original Medicare will automatically begin on January 1, but keep in mind that drug coverage will end—and for those receiving Extra Help, there may be an automatic reassignment.

It’s important to note that Original Medicare doesn’t include an annual out-of-pocket cap. For 2026, the Part B premium will be $202.90 monthly, with a $283 deductible, and Part A’s deductible will be $1,700. Recently, an insurer announced plans to end coverage for approximately 600,000 Medicare Advantage members in 2027, so if you receive an early notice letter, see it as an opportunity to carefully review your replacement options—planning ahead is key to protecting your health and finances.

You’ll have Medigap guaranteed-issue rights beginning 60 days before your plan ends and lasting 63 days after. However, if you go more than 63 days without drug coverage, you could face permanent Part D penalties. To maintain uninterrupted protection, make your new plan selection by December 31. Review every prescription, drug tier, and preferred pharmacy to ensure your coverage meets your needs—whether you choose a new Advantage plan or Original Medicare with Part D.

My role as an advisor is to help clients safeguard their assets and navigate transitions like these with confidence and clarity.

Navigating nursing home care for a loved one involves more than just medical decisions—it’s about protecting the financial well-being of both spouses. Current federal guidelines allow the spouse remaining at home to retain between $32,500 and $162,700 in countable assets, with each state setting its own limit within that range. The snapshot of your assets is taken at the start of institutional care, locking in what counts and what doesn’t. Fortunately, your primary residence, one vehicle, household goods, and prepaid funeral plans are usually exempt from this calculation. Many families find that spend-down strategies—like paying off debt, making home repairs, or covering care costs not covered by insurance—can help them stay within these rules. However, transferring assets or gifting money below market value within five years can trigger penalties, so it’s important to focus on approved transactions. In some cases, a properly structured annuity can convert excess resources into steady monthly income for the at-home spouse, provided it’s irrevocable, pays out in equal installments, and names the state as the primary beneficiary.

Having guided many families through these complex choices as a Life, Annuities, and Medicare Health Advisor, I know how important it is to balance care needs with financial security. If you’re considering long-term care options, it’s always wise to seek advice tailored to your unique situation.