As of 2026, 35.2 million people are enrolled in Medicare Advantage, a private insurance alternative to Original Medicare that bundles hospital and medical coverage and typically includes prescription drug coverage.
If you’re new to Medicare or considering switching your current plan, understanding the Medicare Advantage enrollment process is an important first step. This guide covers what you need to know to sign up, including eligibility requirements and enrollment periods. And if you’re not sure whether Medicare Advantage is right for you, Chapter’s licensed Medicare Advisors can help you compare every Medicare coverage option, including Medigap, Medicare Advantage, and Part D.
Key takeaways
You need to be enrolled in Medicare Part A and Part B and live in a plan’s service area to be eligible for Medicare Advantage.
You may only sign up for Medicare Advantage during specific windows, such as your Initial Enrollment Period, the Annual Enrollment Period, or a Special Enrollment Period tied to a qualifying life event.
Provider networks, prescriptions, and cost-sharing structures vary depending on the Medicare Advantage plan you choose. Comparing plans can help determine which one best fits your needs.
Who is eligible for Medicare Advantage?
Medicare Advantage plans, also called Part C, are Medicare-approved health plans offered by private insurance companies as an alternative to Original Medicare. Medicare Advantage Plans are required to cover at least the same services and equipment as Original Medicare. They often also offer coverage for services that Original Medicare doesn’t, including routine dental, vision, and hearing care.
Medicare Advantage eligibility requirements include:
Being a citizen or lawfully present in the U.S.
Being enrolled in both Medicare Part A and Part B (Original Medicare)
Living in a plan’s service area
Plan availability varies by ZIP code. You can check which plans are available by talking to a licensed Medicare agent or checking the Medicare.gov plan finder tool.
When can you enroll in Medicare Advantage?
You can only sign up for a Medicare Advantage plan during certain windows called enrollment periods.
Initial Enrollment Period
Your Initial Enrollment Period occurs when you age into Medicare. It’s a seven-month window that starts three months before the month you turn 65, includes your birthday month, and ends three months after. During Initial Enrollment, you can sign up for Original Medicare, which is made up of Part A and Part B. Once you are enrolled in both Part A and Part B, you can choose to enroll in a Medicare Advantage plan in your area.
Your Medicare Advantage coverage start date depends on when you signed up.
| When You Sign Up | Coverage Start Date |
|---|---|
| The first three months of your Initial Enrollment Period | The first day of the month you turn 65* *If you were born on the first of the month, your coverage starts the first date of the month before your birthday |
| The month you turn 65 | The first day of the month after you sign up |
| The last three months of your Initial Enrollment Period | The first day of the month after you sign up |
Annual Enrollment Period
The Annual Enrollment Period runs from October 15 to December 7 each year. During this window, anyone with Medicare Part A and Part B can join, switch, or drop a Medicare Advantage plan. Coverage changes made during this period take effect on January 1 of the following year.
Medicare Advantage Open Enrollment Period
The Medicare Advantage Open Enrollment Period runs from January 1 to March 31 each year. The window is available only to people already enrolled in Medicare Advantage and want to change from one Medicare Advantage plan to another. During this period, you can switch to a different Medicare Advantage plan or return to Original Medicare. You can’t use this period to switch from Original Medicare to Medicare Advantage.
Coverage changes made during the Medicare Advantage Open Enrollment Period take effect the first day of the month after you make the change.
Special Enrollment Periods
Special Enrollment Periods (SEPs) are triggered by specific life events that allow you to make Medicare Advantage changes outside the standard windows. Common qualifying events include:
Moving out of your plan’s service area
Losing other qualifying coverage, such as employer or union-sponsored coverage
Your plan leaving Medicare or reducing its service area
Qualifying for Extra Help or a Medicare Savings Program
Moving into or out of a nursing home or other institutional setting
The length and scope of a Special Enrollment Period depends on the triggering event. For example, if you move out of your plan’s service area or lose employer-sponsored coverage, you typically get two full months to make a change. If you’re no longer eligible for Medicaid or find out you won’t qualify for Extra Help, you get three full months. If you think you may qualify for a Special Enrollment Period, confirm the exact window before taking action.
How do you enroll in a Medicare Advantage plan?
After confirming you’re eligible and have a valid enrollment window, the next steps are comparing Medicare Advantage plans available in your area and submitting an application.
Here is how the enrollment process works:
Find plans in your area: Use the Medicare.gov plan finder or work with a Chapter Medicare Advisor to see which plans are available in your ZIP code. Plan availability varies significantly by location.
Gather your information: Have your Medicare ID number, the names of your current doctors and prescriptions, and your preferred pharmacies ready before you compare plans.
Review plan details carefully: Are your doctors in network? Are your prescriptions covered, and how much do they cost? Check out-of-pocket maximums, copays for specialist visits and hospital stays, and any extra benefits like dental, vision, or hearing coverage. Most Medicare Advantage plans include Medicare Part D coverage for prescription drugs, but some don’t. Confirm that your medications are covered before enrolling.
Submit your application: You can enroll directly through the plan’s website, call the private insurer, use Medicare.gov, or work with a licensed Medicare Advisor who can enroll you.
Can you switch to a Medicare Advantage plan after enrolling in Original Medicare?
Yes, you can switch from Original Medicare to a Medicare Advantage plan during a valid enrollment period. Before you switch, it’s important to understand the pros and cons of Medicare Advantage.
Before switching, compare Original Medicare and Medicare Advantage with your needs and keep the following factors in mind:
Provider networks: With Medicare Advantage you’ll need to use doctors, specialists, and hospitals in your plan’s local network to get full coverage for non-emergency care. Some plans, like PPOs, cover out-of-network care at a higher out-of-pocket cost, while others, like HMOs, may not cover non-emergency out-of-network care at all. With Original Medicare, however, you can see any doctor who accepts Medicare nationwide.
Drug formularies: Most Medicare Advantage plans include Part D coverage, but each plan has its own list of covered drugs. Confirm that your current medications are covered—and check how much you’ll need to pay for them—before switching.
Out-of-pocket costs: Medicare Advantage plans have varying costs. Check a plan’s out-of-pocket maximum, deductible, and coinsurance amounts to understand how much you may need to pay out of pocket.
Extra benefits: Medicare Advantage plans come with extra benefits, like dental, vision, and hearing coverage, OTC allowances, and fitness memberships. Consider the benefits that will provide the most value to you when choosing a Medicare Advantage plan.
Understanding these details upfront can help you avoid a Medicare Advantage headache. Many people leave Medicare Advantage because of higher out-of-pocket costs, frustrating network restrictions, and prior authorization denials that limit their access to care.
Get help with Medicare Advantage enrollment
If you’ve decided you want to enroll in Medicare Advantage, it’s important to compare your options carefully because plans vary widely. We recommend using an independent Medicare agent to compare plans against your specific needs.
Chapter offers free Medicare advice from licensed, independent Medicare Advisors. They can help you understand enrollment windows, compare every Medicare Advantage plan against your health and financial needs, and decide which plan is right for you.
Chat with us today at 855-900-2427 or book an appointment ahead of time. We’re here to help.
