Thinking About an Upgrade? How the 5-Star Special Enrollment Period Works

2026.01.12_February Medicare Blog

If a 5-Star Medicare Advantage or Part D plan is offered where you live, you can use a one-time Special Enrollment Period to switch anytime from Dec 8 through Nov 30—including right now in February. It’s a handy option if you missed AEP or your January experience wasn’t what you expected.

What “5-Star” means

Medicare rates plans 1–5 stars for quality and performance so you can compare options. A 5-Star plan earned the highest overall score in the latest ratings cycle. You can check what’s available in your county on Medicare’s Plan Finder.

How switching works

  • You can use the 5-Star SEP once during the window.
  • If you apply now, new coverage generally starts the first of the month after the plan gets your request. (Example: apply in February → starts March 1.)
  • Be careful about drug coverage: moving from an MA-PD (with drugs) to a 5-Star MA plan without drugs could leave you without Part D until your next enrollment chance (and a penalty could apply). Your broker will help you avoid gaps.

5 quick steps to decide

  1. List your meds (name/dose) and preferred pharmacies.
  2. Confirm your doctors/hospitals—are they in the 5-Star plan’s network?
  3. Compare total costs (premium + copays + drug costs) on Plan Finder.
  4. Check extras (dental, vision, OTC, fitness) and any prior-auth rules.
  5. Choose timing: You can also use the Medicare Advantage Open Enrollment Period (Jan 1–Mar 31) if you’re already in MA—your broker can tell you which path fits best.

Want to see if a 5-Star plan is in your area—or run a side-by-side with your current plan? Send your broker your medication list and doctor wish-list. We’ll compare options and, if it’s a win, handle the switch for you.

Facebook
Twitter
LinkedIn

Subscribe to Our Blog

Leave a Reply

Your email address will not be published. Required fields are marked *