How health insurance works
Have questions about how health insurance works? We’ve got answers.
Whether you’re looking for a Medicare Advantage plan with more coverage, higher quality or lower costs, you can only make changes to your Medicare coverage during certain times of the year. These are known as enrollment periods, and they take place just two times a year.
The two enrollment periods for making changes are Medicare’s open enrollment period and Medicare Advantage open enrollment period.
“Mark the enrollment period dates in your calendar,” says Don Truong, director of sales at Sharp Health Plan. “Many Medicare Advantage plans offer $0 monthly premiums, $0 doctor visits, comprehensive dental benefits, vision and hearing aid allowances, global emergency services and more. Missing these dates can mean missing out on extra coverage.”
Special circumstances allow you to make plan changes any time of the year
When certain events happen in your life, such as moving or leaving coverage from your employer or union, you get an opportunity to change your Medicare health and drug coverage. These opportunities are called “special enrollment periods.”
Many situations qualify you for a special enrollment period, and each situation has different rules. You can read details about special enrollment periods at Medicare.gov.
Look for quality when considering a new plan
Not all Medicare Advantage plans are the same. Medicare helps shoppers compare the quality of plans by assigning star ratings to Medicare health and drug plans.
Every year, Medicare evaluates plans based on a five-star rating system. Five stars means excellent overall quality and performance. “Choosing a plan with a lower star rating can impact the quality of care or service you receive,” Truong says.
Medicare's star ratings for 2025 were released last month. You can use Medicare’s plan finder tool to see plans’ star ratings. "Sharp Health Plan is the highest member-rated Medicare Advantage plan in California, and earned a 4-star rating from Medicare," says Truong.
"Sharp Health Plan was also the only plan to be included in the 2025 U.S. News and World Report list of Best Insurance Companies for Medicare Advantage in California," Troung says. "It's great validation to our entire team that we're delivering the same benefits as Original Medicare and more at the highest level of quality."
Get help understanding your options
Free help is available to learn more about your Medicare health and drug coverage options. Truong recommends these trusted resources:
Call 1-800-MEDICARE (1-800-633-4227). Medicare is available 24 hours a day, seven days a week. TTY and TDD users should call 1-877-486-2048.
Contact the Health Insurance Counseling and Advocacy Program (HICAP). HICAP provides objective information and counseling about Medicare. Call California’s HICAP hotline at 1-800-434-0222 or contact the San Diego HICAP office at 858-565-8772 from 8 am to 5 pm on weekdays.
Read “Medicare & You 2025” Every fall, this booklet is mailed to people with Medicare. It has a summary of Medicare benefits, rights and protections, and answers to the most frequently asked questions about Medicare. You can get a copy of this booklet from Medicare.gov.
Reach out to Sharp Health Plan. Certified enrollment specialists are available to answer your questions and offer advice to help you find the best plan for your health needs. You can reach them by email or phone at 858-499-8232. Or go to sharpdirectadvantage.com for more information.
When shopping for Medicare, Truong recommends marking your calendar with Medicare’s enrollment dates. He also encourages you to remember that quality matters and it's important to get personalized help to find the right, most cost-effective plan for you.
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