Medicare Annual Enrollment Period Guide

Overview

  • The Medicare Annual Enrollment Period (AEP) is your chance to make changes to existing coverage from October 15 to December 7. You can switch Medicare Advantage plans, change Part D drug coverage, or move between Original Medicare and Advantage.
  • Not reviewing your current plan can lead to unexpected costs or coverage gaps. Plans often change annually, so checking your Annual Notice of Change (ANOC) is essential.
  • Medicare Advantage, Medigap and Part D plans each work differently and have specific enrollment rules. For example, while the AEP lets you switch back to Original Medicare, it doesn’t guarantee easy access to Medigap.
  • Many people miss out on better options or pay more simply because they didn’t get help. Medicare can be complex—working with a trusted advisor can help you compare plans, clarify confusing terms, and make confident decisions.

The Medicare Annual Enrollment Period (AEP) happens each year from October 15 through December 7. It’s the time when you can review your Medicare coverage and make changes—whether that’s switching plans, updating your drug coverage, or just making sure your health insurance still fits your needs and budget.

It’s no secret that Medicare rules and government jargon can give you the urge to toss your morning coffee at your computer screen. But the Annual Enrollment Period doesn’t have to be confusing. With free resources like this guide and the help of trusted advisors, you can cut through the AEP jargon and make confident choices.

In this guide, we’ll walk you through exactly what the AEP is, what you can and can’t do during this time, and how to prepare for it so you feel confident in your coverage.

What Is the Annual Enrollment Period?

Snapshot

If you’ve been wanting to make a change, this is your chance to join a Medicare Advantage plan, drop your current one, or switch to another. And if you have Original Medicare, you have those same options for making changes to your drug plan.

During the AEP, you can make changes to your Medicare coverage if (and only if) you’re already enrolled. These may include:

  • Switching between Original Medicare (often called Parts A and B) and Medicare Advantage (Part C)
  • Switching your Medicare Advantage plan
  • Adding, dropping or changing a Part D prescription drug plan

The AEP is an important time for reviewing your current coverage, comparing other options, and making sure your plan still meets your health care and financial needs. Any changes you make during this time will go into effect on January 1 of the following year.

Tip: The AEP is not the enrollment period for you if you’re looking to sign up for Medicare for the first time. That’s what your Initial Enrollment Period (IEP) or Special Enrollment Period (SEP) is for.

When Is the Annual Enrollment Period?

Annual Enrollment for existing customers is Oct. 15–Dec 7

This event rolls around every fall and runs from October 15 to December 7. If you’re enrolled in Medicare, those dates are worth noting on your calendar. After all, it’s normally the only time each year you can make changes to your plan (other than a circumstance that triggers a Special Enrollment Period for you).

What Can You Do During the Annual Enrollment Period?

Snapshot

The AEP lets you make various changes to your Medicare coverage, including switching from Original Medicare to Medicare Advantage (or vice versa), choosing another Advantage plan, or adjusting your prescription drug plan.

Switch From Original Medicare to a Medicare Advantage Plan

Are those unlimited out-of-pocket expenses from your Original Medicare plan cramping your style (and draining your bank account)? Now’s the time to switch over to an all-in-one Medicare Advantage plan. Most plans include drug coverage, and many also have extra benefits like vision, dental or hearing.

Switch From a Medicare Advantage Plan to Original Medicare

Frustrated with the limits of your Medicare Advantage network? Original Medicare gives you the freedom to see any provider who accepts Medicare. But here’s the trade-off: You’ll lose the built-in cap on out-of-pocket costs that comes with your Advantage plan.

Tip: If you think that neither Original Medicare nor Medicare Advantage will meet your health insurance needs, a Medigap plan might be the solution—it will supplement your Original plan. Check out our article on Medigap plans to learn more.

Change From Your Current Medicare Advantage Plan to Another

If you’re already in a Medicare Advantage plan, the AEP is your once-a-year opportunity to switch to a different one for any of these advantages:

  • Better coverage
  • Cheaper costs
  • More suitable provider networks

Tip: Don’t assume you have to make coverage changes during the AEP. If you’re still happy with your current Medicare coverage after you review any upcoming changes (more about that in a minute), you can cross this off your list until next fall. But remember, some Medicare Advantage plans require annual re-enrollment, so be sure to check on yours.

Add, Drop or Change a Medicare Prescription Drug (Part D) Plan

Finally, the AEP lets you make changes to your prescription drug (Part D) plan. Here are your options:

  • If you’re currently enrolled in Original Medicare, you can add a Part D plan.
  • You can switch your current drug coverage to another one.
  • If you no longer need prescription coverage (congrats!), you can simply drop your Part D plan.

Tip: If you’re signing up for Medicare Advantage this AEP, do not sign up for a separate Part D plan. Doing so would automatically cancel your Advantage plan and revert you to Original Medicare. (Most Advantage plans already include prescription drug coverage anyway.)

Common Annual Enrollment Period Mistakes to Avoid

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AEP pitfalls are everywhere, from overlooking the drug coverage changes to forgetting to compare plans or even missing the December 7 deadline. Be prepared!

Now that you’re armed with all the details about the AEP, we hope you’re feeling more confident than ever about getting the right Medicare coverage. But you know what would feel even better? Being aware of the most common AEP mistakes to avoid!

Seriously. Every year, way more people than you might expect hit pitfalls with their Medicare enrollment. And the mistakes can be costly. (Can we just blame these kinds of errors on government incompetence? Probably.) But you can easily avoid most of these potential problems just by watching for them and taking proactive steps.

Let’s go over the most common mistakes to avoid.

Not Reviewing Your Current Plan

Mistake: Sometimes people ignore the AEP, assuming their current Medicare Advantage or Part D drug plan will remain the same and telling themselves they don’t need to do anything. (We get it. Who wants to fill out forms if you can avoid it?)

How it could cost you: What worked for you last year may not work next year. Advantage plans are offered through private insurance companies, so they often change provider networks, coverage rules, premiums and the list of drugs the plan covers—and those changes can happen every year.

The AEP is no time for “set it and forget it.” Every fall, your provider will send you a document called your Annual Notice of Change (ANOC). It outlines all the coming year’s changes to your current plan. Review it to be sure you don’t need to make any adjustments during the AEP.

And if you need advice, our friends at Chapter are RamseyTrusted® advisors who can help you understand which plan is best for you.

Misunderstanding the Differences Between Medicare Advantage and Medigap

Mistake: Many Medicare users confuse Medicare Advantage with Medicare Supplement (Medigap) plans.

The facts: While the names might sound similar, Medicare Advantage and Medigap are very different kinds of coverage. Medicare Advantage is Original Medicare bundled with some extras, but it has no out-of-pocket max. Medigap is designed to supplement Original Medicare by helping cover coinsurances and deductibles. You can get way more details about how Medicare works here.

Assuming That Since the AEP Lets You Switch to Original Medicare, It Also Lets You Add Medigap

Mistake: By now you realize that the AEP is your opportunity to switch out of Medicare Advantage (Part C) and into Original Medicare. So you might assume that adding a supplemental Medigap plan is also fair game during the AEP.

The facts: Although the AEP does allow you to switch the specific Medicare Advantage or Part D plan you’re in, and lets you switch from Medicare Advantage back to Original Medicare, the AEP is not the usual time to add a Medigap plan. Normally, you would sign up for Medigap within the first six months after enrolling in Original Medicare—something most people do during their Initial Enrollment Period (IEP) in the months leading up to and following their 65th birthday. If you’re switching back to Original during the AEP and want to add Medigap, you’ll have to do one of the following:

  • Apply for Medigap separately. Keep in mind that insurers can now charge you more than you would’ve paid originally—or even deny you coverage completely, depending on your preexisting conditions.
  • Enroll under a special guaranteed issue situation like moving out of your Advantage plan’s service area, switching back from an Advantage plan within the first year of trying it, or losing an employer health care plan.

Assuming All Doctors Accept Medicare Advantage Plans

Mistake: Are you noticing how many of these classic AEP mistakes involve some form of assumption? Here’s another one: assuming your preferred doctor or hospital is in-network for the Medicare Advantage plan you’re considering.

How it could cost you: Many Medicare Advantage plans have limited provider networks. If you forgot to confirm that your usual providers are in-network for your new Advantage plan during the AEP, you’ll have to decide if sticking with your current providers is worth the higher cost (or even noncoverage) of going out of network.

Not Checking Drug Prescription Lists

Mistake: Since long lists of prescription drugs (sometimes called formularies in Medicare forms) can be boring or intimidating, it’s no surprise that many Medicare participants forget to make sure their medication is covered under their plan each year.

How it could cost you: Prescription drugs are obviously a big deal for both your wallet and your health. So forgetting to check up on coverage and price within your specific Part D or Advantage plan during the AEP could be expensive and dangerous. Drug formularies vary a lot. Look to see if your new plan covers your medication, and keep in mind that it might require higher copays than your old plan.

Not Getting Help When You Need It

Mistake: We understand the appeal of the can-do attitude when it comes time to sign up during the AEP. After all, no one cares more about your money and your health than you do! But we also know from personal experience and plenty of customer stories that Medicare is super confusing. When you need help, the AEP is no time to go rogue without any advice from people in the know.

How it could cost you: Signing up for coverage you don’t need or don’t fully understand could cost you plenty and in several ways. Being unable to cover medical bills is only the biggest and most obvious one—you could also experience coverage gaps, high out-of-network costs or delays in treatment.

This AEP, don’t let those problems set you back. Get help from our RamseyTrusted friends at Chapter.

Missing the Deadline

Mistake: We all know life’s busy. Sometimes people get so slammed, they completely forget to make their Medicare changes by the December 7 AEP deadline.

How it could cost you: If you miss the deadline, you may be stuck with your current plan for another year—or worse, face late penalties or a coverage gap.

So put this deadline on your desk calendar or in your phone reminders, or cover your computer in sticky notes. Do whatever it takes to be sure this deadline doesn’t pass you by.

What Happens if You Miss the AEP Deadline?

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Missing the AEP deadline can lead to some costly consequences—but not always. The results mostly depend on your own situation and what kind of changes you were planning to make. Your only options for making a change after the AEP are waiting till next year or qualifying for a Special Enrollment Period.

You’ll Be Stuck With Your Current Plan for Another Year

If you don’t make any changes during the AEP—let’s say you forgot to look at the documents—you’ll probably just remain in your current plan (Medicare Advantage or Part D) until the next AEP. That’s right—another year of your current plan by default. And that holds even if the plan’s costs or benefits change (another good reminder to get familiar with your plan’s ANOC).

The only way to make a change after the deadline is by qualifying for a Special Enrollment Period (SEP) because you moved, lost coverage, or became eligible for Medicaid.

As we’ve already mentioned above with other common AEP mistakes, just sliding by default into last year’s Medicare plan could mean higher costs or losing access to your preferred doctors or medications.

You’ll Pay More Than You Want for a Prescription Drug (Part D) Plan

Let’s say you were planning to make a change to your prescription drug (Part D) plan during the AEP, but whoops! The deadline flew by and now you’re stuck with your original and automatically renewed drug plan—you know, the one you wanted to change to save money? Well, now that you’ve missed your AEP deadline, you’ll just have to stick with your current plan until next fall or hope you somehow qualify for a Special Enrollment Period.

Get Help From Licensed Advisors

We really hope you’ve learned a lot from our AEP guide—and that you resisted the urge to douse your computer with cold coffee! Even though Medicare’s rules and regulations can be frustrating, they don’t have to be— especially when you’re taking on the AEP armed with plenty of knowledge and help.

And hey, if the thought of dealing with the AEP still has your head spinning, we have good news!

There are folks who felt just like you. But they learned the ins and outs of Medicare—and now they’re here to help you navigate it with confidence. The good people at Chapter will walk you through your options and help you pick the right Medicare plan for your needs—not the one that puts the most money in an agent’s pockets. And Chapter advisors don’t stop there. After you’ve enrolled, they’ll help you use your benefits and get the most out of Medicare.

Next Steps

  • Learn more about the advantages of working with a Medicare advisor.
  • Once you’re about three months away from your 65th birthday, get in touch with our friends at Chapter. They’re RamseyTrusted advisors who can help you figure out a plan that works best for you.