Medicare has several enrollment periods, and it is easy to mix them up. One of the most talked-about is the Medicare Annual Enrollment Period, often called AEP or the fall enrollment period.
This is the time each year when many people review their Medicare coverage and decide whether they want to make changes for the following year. It can be especially important if your prescriptions, doctors, health needs, or plan costs have changed.
However, the rules are not the same for every type of Medicare coverage. Medicare Advantage and Part D drug plans can usually be changed during AEP. Medicare Supplement, also called Medigap, plans follow different rules.
When is the Medicare Annual Enrollment Period?
The Medicare Annual Enrollment Period runs from October 15 through December 7 each year. Changes you make during this window generally begin on January 1 of the next year.
During the fall, Medicare Advantage and Part D plans send an Annual Notice of Change. This notice explains how the plan may change next year. It may include changes to the premium, deductible, copays, drug list, pharmacy network, or provider network.
Even if you have been happy with your coverage, it can be wise to review this notice. A plan that fit well this year may work differently next year.
What can you change during Medicare AEP?
During Annual Enrollment, you may be able to make several changes to your Medicare coverage:
- Move from Original Medicare to a Medicare Advantage plan
- Leave a Medicare Advantage plan and return to Original Medicare
- Switch from one Medicare Advantage plan to another
- Join a stand-alone Medicare Part D prescription drug plan
- Switch from one Part D prescription drug plan to another
- Drop Medicare Advantage or Part D coverage in some situations
Original Medicare includes Part A, which helps cover hospital care, and Part B, which helps cover outpatient and doctor services. A Medicare Advantage plan is another way to receive Medicare-covered benefits through a private insurance company.
Both choices can work well for different people. Medicare Advantage plans may offer lower monthly premiums and extra benefits, while Original Medicare paired with a Medicare Supplement plan may offer broader provider access and more predictable out-of-pocket medical costs. The right fit often depends on your budget, travel habits, doctors, and comfort with plan rules.
Can you change your Medicare Supplement plan during AEP?
You can apply to change Medicare Supplement plans at many times of the year. But the Annual Enrollment Period does not automatically give you the right to switch to a new Medigap plan without health questions.
This is an important difference. In most states, if you apply for a new Medicare Supplement plan after your one-time Medigap Open Enrollment Period has ended, the insurance company may ask health questions. This is called medical underwriting.
Depending on your health and the rules in your state, the carrier may accept your application, charge a different premium, or decline the application. Some states have additional consumer protections or special enrollment opportunities, so rules can vary by state and carrier.
If you already have a Medicare Supplement plan and are thinking about changing it, it is usually best not to cancel your current plan until you know whether the new coverage has been approved and when it will begin.
Why should you review your Part D drug plan every year?
Part D plans can change from year to year, even when the plan name stays the same. Your medications may also change. That is why reviewing your drug coverage during AEP can be helpful.
When comparing Part D plans, consider:
- Whether your prescriptions are on the plan’s covered drug list, called a formulary
- What coverage rules may apply, such as prior authorization or quantity limits
- Whether your preferred pharmacy is in the plan’s network
- How much your medicines may cost at different pharmacies
- Whether mail-order pharmacy service is available if that matters to you
A Part D plan with a low premium may not always be the best overall choice if it does not cover your medications well. On the other hand, a plan with broader drug coverage may not be necessary if you take few prescriptions. Comparing your specific medication list can make the decision clearer.
What happens if you do nothing during Annual Enrollment?
If you are enrolled in a Medicare Advantage plan or Part D prescription drug plan and do nothing, you will generally remain in your current plan for the next year. Your plan may still have new costs, coverage rules, or provider and pharmacy networks.
If you have Original Medicare with a Medicare Supplement plan, you can generally keep that coverage as long as you continue paying your premiums. You do not need to re-enroll in your Medicare Supplement plan each fall.
Still, reviewing your coverage may be worthwhile. For example, a Part D plan that covered your medications this year may place one of them in a different cost tier next year. Or a Medicare Advantage plan may no longer include a doctor you want to see.
Is AEP the same as Medicare Advantage Open Enrollment?
No. These are two different time periods.
The Medicare Annual Enrollment Period is October 15 through December 7. It is available to people with Medicare and allows a range of Medicare Advantage and Part D changes.
The Medicare Advantage Open Enrollment Period runs from January 1 through March 31. It is only for people who are already enrolled in a Medicare Advantage plan. During this period, they may switch to another Medicare Advantage plan or return to Original Medicare and join a Part D plan.
People cannot generally use the January through March period to make a stand-alone Part D change if they have Original Medicare without Medicare Advantage.
How can you prepare for Medicare Annual Enrollment?
Start by gathering a current list of your prescriptions, including the dosage and how often you take each one. Then review your plan’s Annual Notice of Change when it arrives in the fall.
You may also want to think about whether your health needs have changed. Are you seeing new specialists? Do you expect to travel more? Are your favorite doctors and pharmacies still available through your plan? These questions can help you decide whether your current coverage still fits.
If you have a Medicare Supplement plan, remember that switching plans may involve health underwriting outside certain protected situations. Eric can help you understand the timing, compare Medicare Supplement options available in your state, and review how they may work with Part D coverage. Reach out for free, no-pressure help as you prepare for Medicare enrollment decisions.