Updated: Nov 21, 2024

The Annual Enrollment Period (AEP) is your opportunity to review your Medicare plan with a licensed agent and make sure you’re taking full advantage of available benefits. Be proactive and ensure your plan fits your current needs.

Taking the time to research different options can uncover hidden benefits or cost savings that might be missed with a quick review, so compare plans carefully. By staying informed and exploring all your options, you can make confident decisions that support your well-being and financial peace of mind.

The Annual Enrollment Period (AEP) is a specific window of time when individuals who are enrolled in Medicare can make changes to their coverage. Occurring every year from October 15 to December 7, this period allows Medicare beneficiaries to review their current plans and make adjustments based on their healthcare needs for the upcoming year. Understanding how AEP works, what changes you can make, and the key deadlines is crucial to ensuring you have the right Medicare coverage. In this guide, we’ll break down everything you need to know about the Annual Enrollment Period and how to make the most of it.

What Is the Medicare Annual Enrollment Period (AEP)?

The Medicare Annual Enrollment Period is an annual window in which people with Medicare can make changes to their Medicare plans. During this period, you have the opportunity to adjust your Medicare Advantage (Part C) or Medicare Prescription Drug Plan (Part D) coverage. Here are the key points to understand:

• When It Happens: AEP runs from October 15 to December 7 every year. Any changes you make during this period will take effect on January 1 of the following year.
• Who It Affects: The Annual Enrollment Period applies to anyone currently enrolled in Medicare. It’s especially important for people with Medicare Advantage plans or Medicare Part D prescription drug coverage, as this is the main time you can make changes to these plans.
• What You Can Do: During AEP, you can make changes to your Medicare Advantage or Part D plan, including switching plans or dropping your coverage.

What Changes Can You Make During AEP?

During the Annual Enrollment Period, you have the flexibility to make several types of changes to your Medicare coverage. Here’s what you can do:

1. Switch from Original Medicare to Medicare Advantage (Part C)

If you’re enrolled in Original Medicare (Parts A and B) but want to join a Medicare Advantage plan, AEP is the time to make that switch. Medicare Advantage plans often offer additional benefits, such as dental, vision, hearing, and even prescription drug coverage, that Original Medicare doesn’t provide.

2. Switch from Medicare Advantage Back to Original Medicare

If you’re currently enrolled in a Medicare Advantage plan but prefer to return to Original Medicare, you can do that during AEP. You may also want to consider enrolling in a Medigap (Medicare Supplement) plan to help cover some of the out-of-pocket costs that Original Medicare doesn’t cover, such as co-pays, coinsurance, and deductibles.

3. Change Medicare Advantage Plans

If you’re already enrolled in Medicare Advantage, you can use AEP to switch to a different Medicare Advantage plan that might better suit your needs. This is especially important if your current plan has changed its network of doctors, benefits, or drug formulary, or if your health needs have changed.

4. Add, Change, or Drop a Part D Prescription Drug Plan

If you’re enrolled in Original Medicare and don’t have a Part D prescription drug plan, AEP is the time to add this coverage. If you already have a Part D plan, you can compare different plans to see if another one offers better coverage or lower costs, or you can drop your Part D coverage entirely.

5. Switch from One Part D Plan to Another

If you’re enrolled in a Medicare Part D plan but want to switch to a different plan (perhaps due to changes in the drug formulary or premiums), you can do that during AEP.

Why Is the Annual Enrollment Period Important?

The Annual Enrollment Period is important because it allows you to ensure your Medicare coverage matches your healthcare needs and budget for the upcoming year. Health and financial circumstances can change, and so can Medicare plans. Here are a few reasons why AEP is crucial:

• Plan Changes: Medicare Advantage and Part D plans often change their benefits, premiums, and provider networks from year to year. Even if you’re satisfied with your current plan, it’s important to review any changes to make sure it still meets your needs.
• Healthcare Needs: If your health has changed or if you’ve started taking new medications, switching to a plan that offers better coverage for your condition or medications can save you money and hassle.
• Cost Savings: Comparing plans during AEP can help you find a plan with lower premiums, deductibles, or co-pays, potentially saving you money throughout the year.
• Coverage Gaps: The AEP is a chance to fix any coverage gaps, like adding prescription drug coverage if you don’t already have it.

Steps to Take Before the Annual Enrollment Period

Before the Annual Enrollment Period begins, it’s important to prepare by reviewing your current coverage, understanding your healthcare needs, and exploring available plans. Here’s what you should do:

1. Review Your Current Plan

Carefully look at the Annual Notice of Change (ANOC) document your insurance company sends you. This outlines any changes in your Medicare Advantage or Part D plan for the upcoming year, including premium changes, changes to the drug formulary, co-pays, and provider networks. If your plan still meets your needs, you may decide to stay with it, but it’s always a good idea to review the alternatives.

2. Assess Your Healthcare Needs

Consider how your healthcare needs have changed over the past year. Are you seeing new doctors? Do you need more specialists? Have you started taking different medications? These changes can impact whether your current plan is still the best fit.

3. Compare Plans

Use Medicare’s Plan Finder Tool on the Medicare website to compare Medicare Advantage and Part D plans in your area. This tool allows you to enter your prescriptions, preferred pharmacies, and other healthcare preferences to find a plan that offers the best coverage at the lowest cost. Also, check whether your preferred doctors and healthcare providers are still in-network if you’re on a Medicare Advantage plan.

4. Check for Extra Benefits

Many Medicare Advantage plans offer benefits that go beyond what Original Medicare covers, such as dental, vision, and hearing care. If these services are important to you, make sure to compare plans that offer these additional benefits.

5. Consider the Cost

Review the total costs associated with each plan, not just the monthly premium. This includes deductibles, co-pays, coinsurance, and any potential out-of-pocket maximums. A plan with a lower premium might cost more overall if it has high co-pays for doctor visits or prescriptions.

What Happens After the Annual Enrollment Period?

Once you’ve made changes to your Medicare plan during the Annual Enrollment Period, your new coverage will take effect on January 1 of the following year. If you don’t make any changes during AEP, your current coverage will automatically renew for the next year, provided that your plan is still available.

It’s important to note that once AEP ends on December 7, you generally can’t make changes to your Medicare Advantage or Part D plans until the next AEP, unless you qualify for a Special Enrollment Period (SEP). SEPs can be triggered by certain life events, such as moving out of your plan’s service area, losing employer coverage, or qualifying for Medicaid.

Additional Medicare Enrollment Periods to Know About

While the Annual Enrollment Period is the main time to make changes to your Medicare coverage, there are a few other important enrollment periods to be aware of:

1. Medicare Open Enrollment Period (January 1 – March 31)

This period allows individuals who are already enrolled in a Medicare Advantage plan to make one change, such as switching to a different Medicare Advantage plan or switching back to Original Medicare (with the option to add a Part D plan). You cannot switch from Original Medicare to a Medicare Advantage plan during this period.

2. Initial Enrollment Period (IEP)

This is your first opportunity to enroll in Medicare when you become eligible. It starts three months before your 65th birthday month and ends three months after your birthday month. During this time, you can sign up for Medicare Part A, Part B, and Part D, or choose a Medicare Advantage plan.

3. Special Enrollment Period (SEP)

If you experience certain life changes, like moving or losing employer-based coverage, you may qualify for a Special Enrollment Period to make changes to your Medicare coverage outside of the AEP.

Conclusion

The Annual Enrollment Period is your opportunity to make sure your Medicare coverage fits your health needs and budget. With the ability to change your Medicare Advantage or Part D plans, AEP offers flexibility and control over your healthcare. Be sure to review your plan options, compare costs, and understand any changes to your current coverage. By preparing ahead of time, you can make informed decisions that will give you peace of mind and potentially save you money in the coming year.