What You Need to Know About Medicare Annual Enrollment Period
Nearly 64 million people use Medicare insurance for their healthcare needs. They are constantly bombarded with advertisements and marketing to get them to review different options. The closer we get to the Annual Enrollment Period, the more we see these advertisements.
Annual Enrollment Period
Every year individuals enrolled in Medicare have the option to make changes to these plans. This Annual Enrollment Period or AEP occurs between October 15 and December 7.
During the AEP, Medicare beneficiaries can enroll, change, or disenroll from Medicare coverage. There isn’t a limit on how many times they can change. However, the last change will be the one that takes effect. All plan changes will begin on January 1.
Coverage Affected by the Annual Enrollment Period
The Annual Enrollment Period only affects Medicare Advantage and Part D prescription drug plans. The AEP is one of the few times individuals can change either of these coverages a year.
Many beneficiaries mistakenly think they must use the AEP to change their Medicare Supplement Plans. You can change a Medicare Supplement anytime, as long as you are healthy enough to pass medical underwriting.
Annual Enrollment Period vs. Open Enrollment Period
There is a lot of confusion around the term Open Enrollment Period (OEP). Many mistakenly refer to the AEP as Open Enrollment. However, two distinct periods called Open Enrollment affect different Medicare plan options. Both Medicare Advantage and Medicare Supplement plans have an Open Enrollment Period, but each OEP works differently.
Medicare Supplement Open Enrollment
Open Enrollment for Medicare Supplements occurs when you first start your Medicare Part B or turn 65. Enrollment is available to any plan you’re eligible for during this time without needing medical underwriting. The Open OEP begins the first month of your Medicare Part B start date or the month of your 65th birthday and continues for six months.
Most individuals will have one OEP in their lifetime. However, someone that qualifies for Medicare before 65 will have a second OEP when they reach their 65th birthday.
Medicare Advantage Open Enrollment
There’s an Open Enrollment Period each year for Medicare beneficiaries enrolled in a Medicare Advantage Plan. The Medicare Advantage Open Enrollment Period works slightly differently than the AEP.
During the MAOEP, beneficiaries enrolled in an active Medicare Advantage plan can make one change to their coverage. The MAOEP starts January 1 and continues through March 31. Once a beneficiary makes plan changes, the coverage change will begin on the first of the following month.
Beneficiaries can make the following changes during the MAOEP:
- Switch Medicare Advantage plans;
- Drop their Medicare Advantage plan and return to Original Medicare; or
- Drop the MA plan, return to Original Medicare and enroll in a stand-alone Part D prescription drug plan.
Finding the Best Plan for You
Since plan changes can only be made at specific times of the year, this is when you should evaluate your current coverage to other plan options. There are a few things to consider when comparing plan options.
- How does your prescription drug coverage compare to other options?
- Are there doctors you must keep? Are they more important than having lower costs?
- Review plan benefits for extras that meet your needs or wants.
- Review the benefits of copays and out-of-pocket costs.
The best way to review and compare plans is to work with a licensed insurance broker specializing in Medicare. They can access the programs in your area and provide you with a comparison. They can also educate and help identify the plans that meet your needs and help with Enrollment.
Annual Enrollment for Original Medicare
Most Medicare beneficiaries enrolled in traditional Medicare also have a stand-alone prescription drug plan. These beneficiaries can change drug plans or enroll in a Medicare Advantage plan with drug benefits.
Annual Enrollment for Marketplace Plans
Affordable Care Act or Marketplace plans have an annual Open Enrollment period that also occurs in the fall. Annual Enrollment is for Medicare beneficiaries.
Annual Enrollment for Employer Group Coverage or Retiree Plans
From time to time, a Medicare beneficiary will stay on a group or retiree plan. They can potentially make changes during the AEP. However, in many of these cases, upon leaving group or retirement coverage, they can enroll in a plan outside of the AEP.
Making Changes Outside of the Annual Enrollment Period
Medicare Advantage and Prescription Drug Plans are calendar year contracts. Making changes requires a valid enrollment period. Outside of the AEP and MAOEP, changes can’t be made unless there’s a valid Special Enrollment Period (SEP).
SEPs are certain life events or situations, such as moving out of the plan’s coverage area or dual enrollment in Medicare and Medicaid. For individuals with Medicare and Medicaid or receiving help for prescription drugs and Medicare premiums, there’s a quarterly SEP.
Let’s Have a Conversation:
Are you planning on taking advantage of Medicare AEP this year? Have you been meaning to adjust aspects of your coverage? Are you switching to or off of a Medicare Advantage Plan?
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I still work and have enrolled in Medicare but also have my current health plan thru my state agency employer. When I retire I will need need pick up extra coverage like Part D. Is there a special enrollment for this event.
Hi Jeanine! Once you leave your current employer coverage, you’ll qualify for an 8-month Special Enrollment Period to enroll in Part D.
We were planning to drop the Advantage Plan and return to Medicare and add a prescription drug (part D) plan plus look at supplemental plan options. Can we not do that during the Open Enrollment period, commencing October 15th? [The January 1 – March 31 is new to me — but I don’t want to be stuck with the current Advantage Plan.]
Yes you can change Oct 15-Dec 7, effective 1/1/23. OEP 1/1-3/31 is for people who miss AEP or find out the plan they chose is not the right be for them
Hi Katherine! Yes, you can do that during the Medicare Annual Enrollment Period starting in October.
Help!! So confusing! I’m paying $255/month for ?? I still pay for my Rx out of pocket. Which is far less per yr than my secondary coverage is. I need to speak with a pro! How do I go about finding one and what do charge?
After reading this I am almost as confused as I was before reading it, through no fault of author — the topic and variabilities inherent in the system are mind-boggling. What is worse this all happens when people are more vulnerable; many providers and doctors not wanting to deal with Medicare patients at all. Insurance companies are at the ready to take care of every advantage and loophole possible. Surely the “wealthiest industrial country in the world” can have FREE HEALTH CARE FOR ALL!!!, like France, Canada, England, Holland, etc.
Insurance in France, EU,UK is not FREE. We do have to pay for it. TY
Hi Jan! Do you know what coverage you currently have? Is it Medigap or Medicare Advantage? Your prescriptions would be covered under a Medicare Advantage prescription drug plan or Medicare Part D plan. If you only have Medigap, and no Part D plan, then you won’t have coverage for your prescriptions.
Remember, Medicare Advantage is pay-as-you-go. With Medigap, you will pay minimal or nothing out of pocket when you get sick and need medical care. With Medicare Advantage, you will pay significantly more out of pocket when you use the benefits. That’s why Medicare Advantage plans have a MOOP and Medigap does not, because Medigap does not need a MOOP limit.