When is Medicare Open enrollment and what can I do?

When it comes to Medicare and its different parts, there are several enrollment periods throughout the year.

During these enrollment periods, you can enroll in or make changes to the different parts of Medicare or additional coverages that work with Medicare.

We talk to many confused people about what they can do regarding Medicare and when they can do it. 

Today we will talk about different enrollment periods and what you can do during each of them.

Keep reading to learn more.

Comparing plans online

Annual Election Period (AEP)

The Annual Election Period (AEP) occurs each year between October 15 and December 7.

There are several things you can do during the Annual Election Period:

  • Make changes to your Part D prescription drug plan
  • Enroll in a Part D prescription drug plan for the first time
  • Switch from an Advantage plan to Original Medicare plus a supplement
  • Switch from Original Medicare plus a supplement to an Advantage plan
  • Switch from one Advantage plan to another

We will talk about each of these in a bit more detail below.

Making Changes to Part D

Part D plans are plans you purchase from Medicare-approved private insurance companies to help cover the cost of your prescription medications.

We talked about Part D in more detail in another post, which you can read here.

When you enroll in a Part D plan, the drug plan will cover you from January 1-December 31.

During the Annual Election Period, you can change your Part D plan to another if you would like.

Some people may choose to do this if the monthly premium on their current plan increases or if there is a change in their prescription medication needs, and a different plan will cover certain drugs better.

If you enroll in a new drug plan during the Annual Election Period, it begins on January 1 of the coming year.

If you do not enroll in a new drug plan, you will be automatically re-enrolled into your current plan, and there is nothing you need to do.

Enrolling in Part D

If you did not enroll in a Part D drug plan when you were initially eligible to do so, you could enroll in one during the Annual Election Period.

Medicare will likely charge you a late enrollment penalty.

The penalty is how many months you went without Part D drug coverage while you were eligible and did not have any other drug coverage.

The penalty is 1{b4bbd263819068917130d72e822848c45b5fa247d69cd43f0a65a0680d40f992} of the average monthly premium of a Part D drug plan, which is around $33 (in 2020), making the penalty approximately $0.33. 

The average premium changes from year to year and Medicare updates this on their website.

If you are subject to a late enrollment penalty, it is added to your Part D plan’s monthly premium indefinitely.

If you enroll in a Part D plan during the Annual Election Period, your coverage begins January 1.

Changing From an Advantage Plan to Original Medicare

Advantage plans – sold by private insurance companies, approved by Medicare cover all your Part A hospital and Part B medical services.

Some people will get Advantage plans to help minimize their out-of-pocket expenses on Medicare.

When you have an Advantage plan, it replaces Original Medicare Part A and Part B, meaning the Advantage plan becomes your primary insurance instead of Original Medicare.

During the Annual Election Period, many people decide they would like to come off their Advantage plans and go back to Original Medicare with a supplement.

You can purchase supplement plans from Medicare-approved private insurance companies in addition to Part A and Part B to help minimize your out-of-pocket expenses on Medicare.

Medicare supplements are different from Advantage plans in several ways:

  • On a supplement plan, you can see any provider nationwide as long as they accept Medicare; Advantage plans have a network of providers, and you can have much higher out-of-pocket if you go out of network.
  • Supplements have monthly premiums but very little out-of-pocket after that; Advantage plans have little to no monthly premiums but usually very high out-of-pocket when you use your insurance.

Many people with Advantage plans decide that they would like to go back to Original Medicare with a supplement because they have more freedom regarding their choice of doctors and less out-of-pocket when they do need to use their coverage.

During the Annual Election Period, you can switch from your Advantage plan to Original Medicare plus a supplement.

You will be subject to medical underwriting.

This means your supplemental coverage application will include a health questionnaire, and the insurance company may look into your medical and prescription history.

The company will either approve or decline your application based on its findings.

Your supplement plan will begin on January 1 of the coming year if your application is approved.

It is important to note that you will also need to enroll in a Part D plan once your supplemental coverage application is approved.

Most Advantage plans include Part D coverage, whereas no supplement plan provides prescription drug coverage.

Enrolling in a Part D plan will automatically take you off your current Advantage plan on January 1.

Your Part D prescription drug coverage will also begin on January 1, along with your supplement.

We talked about Medicare supplements and Advantage plans in different posts, which you can find using the search tool at the top of this page or on the home page.

Changing From Original Medicare to an Advantage Plan

During the Annual Election Period, you can also change from Original Medicare plus a supplement to an Advantage plan.

Some people feel that monthly premiums for a supplement are not in the budget and decide to switch to an Advantage plan.

You can enroll in any Advantage plan available to you in your area and are never subject to medical underwriting.

Your Advantage plan will begin on January 1 and will likely include prescription drug coverage.

You will need to contact the insurance company you purchased your supplement through and notify that company that you will be canceling your coverage as of January 1.

It is important to note that if you decide later to go back to Original Medicare plus a supplement, you can only do so during the Annual Election Period. You will be subject to medical underwriting.

Changing From One Advantage Plan to Another

If you would like to switch from your Advantage plan to another Advantage plan, you can do so during the Annual Election Period.

There are several reasons that someone would want to switch from one Advantage plan to another:

  • Your preferred provider is in another plan’s network and is no longer in your current plan’s network
  • Services you receive regularly are covered better on a different plan
  • Your drugs are covered better on a different plan
  • Your current plan will no longer be available for the coming year

If you enroll in a different Advantage plan during the Annual Election Period, your new plan begins on January 1 of the coming year, and your current plan ends.

If your current Advantage plan is available next year, and you want to keep it, you will be automatically re-enrolled. There is nothing you need to do.

Medicare Advantage-Open Enrollment Period (MA-OEP)

The Medicare Advantage Open Enrollment Period (MA-OEP) occurs each year between January 1 and March 31.

During the Medicare Advantage Open Enrollment Period, people who already have an Advantage plan can:

  • Switch from one Advantage plan to another
  • Switch from an Advantage plan to Original Medicare plus a supplement

If you switch from one Advantage plan to another, your coverage will begin the first of the month following the month that you enroll in a new plan.

If you switch from an Advantage plan to Original Medicare plus a supplement, applying for a supplement will mean you are subject to the medical underwriting process described above.

Once your application for a supplement is approved, you should enroll in a Part D prescription drug plan because supplement plans do not include prescription medication coverage.

Your supplement and Part D plan will begin the first of the month following the month you enroll.

Any Advantage plan or Part D drug plan you enroll in during the Medicare Advantage Open Enrollment Period will be your coverage through the remainder of the year.

If you wish to switch Advantage or Part D coverage after that, you will have to wait until the Annual Election Period in the fall, and new coverage will begin January 1 of the following year.

General Enrollment Period (GEP)

The General Enrollment Period (GEP) occurs each year from January 1 through March 31.

During the General Enrollment Period, you can enroll in Medicare Part A and Part B if you did not do so when you were initially eligible during your Initial Enrollment Period (IEP) or a Special Enrollment Period (SEP).

If you did not enroll in Part A or Part B when you were first eligible, Medicare would likely charge you a late enrollment penalty.

The Part A late enrollment penalty is 10{b4bbd263819068917130d72e822848c45b5fa247d69cd43f0a65a0680d40f992} of the Part A monthly premium.

The penalty lasts twice as long as you were eligible for Part A but went without it.

For Example

You are eligible for Part A but decide not to sign up for 2 Years. The penalty is 10{b4bbd263819068917130d72e822848c45b5fa247d69cd43f0a65a0680d40f992} of the premium. That penalty will last for four years. 

The Part B late enrollment penalty is 10{b4bbd263819068917130d72e822848c45b5fa247d69cd43f0a65a0680d40f992} of the Part B monthly premium for each 12-month period you were eligible for Part B coverage but went without it.

This penalty is added to your Part B monthly premium indefinitely.

It is important to note that Social Security enrolls most people in premium-free Part A automatically when they turn 65.

We talked about being eligible for and enrolling in Part A and Part B in more detail in different posts, which you can find using the search tool at the top of this page or on the home page.

If you enroll in Part A or Part B during the General Enrollment Period, your coverage will begin on July 1.

Summary

Several enrollment periods allow you to sign up for or make changes to your Medicare and other Medicare-related coverage throughout the year.

During the Annual Election Period that runs from October 15 through December 7 of each year, you can enroll in or make changes to Part D plans and go to or from Orignal Medicare.

During the Medicare Advantage Open Enrollment Period from January 1 through March 31, people with Advantage plans can switch back to Original Medicare, get a drug plan, or switch to another Advantage plan.

During the General Enrollment Period from January 1 through March 31, people who did not sign up for Part A or Part B when they were initially eligible to do so have an opportunity to enroll. Medicare will likely charge a late enrollment penalty.

It is essential to know when these enrollment periods are and what you can do during each of them to avoid missing an opportunity to enroll in or make changes to Medicare or any additional coverage.

If you have any questions, use the search tool at the top of this page or on the home page.

Or, if you would like further detail on any of the topics we discussed, please fill out a contact form and submit your questions.

If you prefer to speak by phone, call us at 888-209-5049.