Table of Contents:

  1. When Is the Annual Enrollment Period?
  2. What Are My Options During the Annual Enrollment Period?
  3. What If I Miss the Annual Enrollment Period?
  4. How Can I Prepare for the Annual Enrollment Period?

For many beneficiaries, the Annual Enrollment Period (AEP) is the one chance they’ll get all year to review their coverage, assess alternative options, and potentially make a change that better suits their healthcare needs and financial situation.

Even if your health and finances haven’t changed this year, it’s possible (even likely) that your preferred Medicare plan has. While certain components of Medicare (like Medicare Advantage’s out-of-pocket spending limit) have remained static for years, many others (like Part D’s various drug formularies) are impossible to predict. Just because you’re satisfied with your coverage so far doesn’t mean you should ignore this year’s Annual Enrollment Period.

When Is the Annual Enrollment Period?

The Annual Enrollment Period takes place from October 15th to December 7th each year. Changes go into effect on January 1st.

What Are My Options During the Annual Enrollment Period?

Like the first period of eligibility, the Annual Enrollment Period presents a number of choices to beneficiaries. Between October 15th and December 7th, Medicare beneficiaries can do any of the following:

  • Switch from Original Medicare to Medicare Advantage or vice versa
  • Switch from one Medicare Advantage plan to another
  • Switch from one Medicare Part D plan to another
  • Enroll in Medicare Part D for the first time (a late enrollment penalty may apply)
  • Drop Medicare Part D coverage

Beneficiaries can make as many changes as they like during this period.

What If I Miss the Annual Enrollment Period?

Medicare Advantage beneficiaries have access to an Open Enrollment Period at the start of each year. From January 1st to March 31st, Medicare Advantage beneficiaries have the following options:

  • Switch from Medicare Advantage to Original Medicare (and, if necessary, select a Medicare Part D plan)
  • Switch to a different Medicare Advantage plan

While the Annual Enrollment Period allows for numerous changes, beneficiaries can only make one change during the Medicare Advantage Open Enrollment Period. This change will go into effect on the 1st of the following month.

Certain events may also trigger a special enrollment period (SEP) for Medicare Advantage and Medicare Part D beneficiaries. These include:

  • Changing ZIP codes
  • Entering long-term care or skilled nursing facilities
  • Losing coverage through Medicaid or an employer-sponsored plan
  • Gaining access to different coverage through an employer, union, or government program

Your options and windows of opportunity during an SEP will vary based on the specific circumstances.

How Can I Prepare for the Annual Enrollment Period?

Whatever your opinion of your current coverage, the AEP provides a yearly opportunity to thoroughly and objectively consider the following:

  • Can I afford my current coverage?
  • Do I expect my health or financial situation to change in the near future?
  • What can I afford to pay in the event of a medical emergency or other life-changing event?
  • Would I benefit from access to any additional perks?

While making these assessments, be sure to consult either the Medicare & You handbook or the literature provided by your private insurance provider. For a quick overview of supplementary insurance options in your area, consult the Medicare Plan Finder.

Still have questions? Contact Marigold to discuss your options with one of our licensed agents.

 

Information adapted from the Centers for Medicare & Medicaid Services