5 Signs Your Medicare Advantage Plan May Not Be the Right Fit

A Medicare Advantage plan may look great on paper — but real-world use often tells a different story. OEP exists to help people who experience those surprises.

Here are five common signs your plan may not be working for you.

1. Your Doctor Is No Longer In-Network

Provider networks can change yearly. If your primary care doctor or specialist is no longer covered, you may face higher costs or need to switch providers.

2. Prescription Costs Are Higher Than Expected

Even if your medications were covered last year, formularies and drug tiers change. Higher copays or prior authorizations can be a red flag.

3. Copays Are Adding Up Quickly

Low premiums don’t always mean low costs. Frequent doctor visits, imaging, therapy, or specialist care can add up faster than anticipated.

4. Your Health Needs Have Changed

A new diagnosis, surgery, or ongoing treatment may require broader coverage or more flexibility than your current plan provides.

5. You Feel Confused Using Your Benefits

If you’re unsure what’s covered, when referrals are required, or how to use your plan effectively, that confusion alone is reason to review your options.

OEP is your opportunity to address these issues before they impact the rest of your year.