Open Enrollment Allows Medicare Beneficiaries to Change Coverage — How Many Are Switching and Why?

The Medicare open enrollment period — a time when beneficiaries can change their coverage — began October 15 and runs through December 7. Medicare beneficiaries receive benefits either through traditional Medicare or a private Medicare Advantage (MA) plan. Deciding between these options and also among Medicare Advantage plans can be challenging: the coverage options have trade-offs, and beneficiaries have diverse needs.

Beneficiaries with traditional Medicare can see nearly any doctor and visit any hospital they choose, with no network limits or prior approval requirements. They may purchase supplemental insurance coverage, known as Medigap, to help cover cost sharing, and a Part D plan to cover prescription drugs. Beneficiaries typically have limited windows of time when they can purchase a Medigap policy without underwriting or being denied coverage.

In addition to medical coverage, Medicare Advantage plans may offer dental, vision, and hearing coverage, as well as other benefits not covered by traditional Medicare. The plans limit out-of-pocket spending on medical services and typically include Part D prescription drug coverage. Medicare Advantage plans have more limited networks of doctors and providers and usually require care to be approved beforehand, a practice known as prior authorization.

Choosing coverage is further complicated by the number of insurers and available plans. In 2025, the average beneficiary is expected to be able to choose among 34 Medicare Advantage and 15 stand-alone Part D plans. Beneficiaries also receive marketing and outreach from plans, brokers and agents, and third-party marketing organizations.

To find out who is switching Medicare coverage, what types of changes they are making, and the reasons behind those decisions, we looked at data from the Commonwealth Fund 2024 Value of Medicare Survey (for more detail, see “How We Conducted This Survey”).

In the past two years, 15 percent of beneficiaries said they switched their coverage. People in Medicare Advantage were more likely to say they had switched coverage than those in traditional Medicare (21% vs. 6%, respectively).

The most common changes were switching from one MA plan to another or from traditional Medicare to an MA plan. Among the 15 percent of all beneficiaries who had switched coverage in the past two years, 35 percent said they switched from traditional Medicare to an MA plan and 49 percent said they switched from one MA plan to another.

Of those who didn’t make changes, 6 percent overall reported wanting to but not having done so, while four of five (79%) said they didn’t switch and didn’t want to. Seventy-three percent of beneficiaries with Medicare Advantage did not switch coverage and did not want to, compared to 88 percent of those with traditional Medicare.

Beneficiaries may switch their coverage for a variety of reasons, but lowering costs and better access to doctors are common concerns. Of those who switched coverage, half of beneficiaries in MA switched to get more benefits covered, compared to 17 percent of beneficiaries in traditional Medicare. A smaller share of beneficiaries in MA said they switched to lower their premiums or copayments (31% in MA vs. 51% in traditional Medicare).

There are other factors that influence beneficiaries; some may be forced to switch. About one of five beneficiaries, regardless of coverage (19% MA vs. 18% traditional Medicare), had to switch because their employer or union coverage options were changing, because their plan was no longer being offered, because they moved, or because they said they lost coverage.

The opinions of friends and family, advice from insurance brokers, or marketing can also play a role in decisions. Significantly more beneficiaries in MA said a broker or agent convinced them to switch their coverage than beneficiaries in traditional Medicare (17% vs. 5%, respectively). Similar percentages of beneficiaries in MA and traditional Medicare said friends and family convinced them to switch to their coverage (7% for each coverage type).

Discussion

Most beneficiaries in this survey said they did not switch their Medicare coverage and did not want to, which may suggest satisfaction with coverage. This is consistent with other evidence of beneficiaries’ satisfaction. In 2024, two-thirds of Medicare beneficiaries said their coverage fully met their expectations, regardless of whether they had Medicare Advantage or traditional Medicare coverage.

For those who did switch, cost and access to more benefits were cited as the main reasons. Switching from traditional Medicare to Medicare Advantage has helped drive MA growth, making it the way a majority of beneficiaries receive their benefits in 2025. However, disenrollment in Medicare Advantage also has grown in recent years.

Understanding the experiences of people who want to switch but don’t, as well as those who must switch as a result of circumstances out of their control, will require additional research. It is important for beneficiaries to be able to change their coverage as their lives and needs change. As enrollment in private plans grows, it will be important for policymakers to monitor switching as it can point to high-performing plans that are improving and meeting the needs of members, but it can also point to plans and markets that are falling short.