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What to Do If You Missed the Medicare Annual Enrollment Period (AEP)

by | Jan 1, 2025 | Medicare, Medicare Advice

What to Do If You Missed the Medicare Annual Enrollment Period (AEP)

What to Do If You Missed the Medicare Annual Enrollment Period (AEP)

Missing the Medicare Annual Enrollment Period (AEP) can feel like a huge setback, but don’t panic. There are still options available to make changes to your Medicare coverage. Let’s explore what you can do if you missed the AEP and how to navigate your next steps.

Understanding the Annual Enrollment Period (AEP)

First, let’s understand what the AEP is:

  • Annual Enrollment Period (AEP): The AEP occurs annually from October 15 to December 7. During this time, you can make changes to your Medicare coverage, including switching between Original Medicare and Medicare Advantage, changing Medicare Advantage plans, or enrolling in a Medicare Part D prescription drug plan.

If You Missed the AEP

If you missed the AEP, don’t worry. Here are some options to consider:

  1. Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31, you can make a one-time change if you’re already enrolled in a Medicare Advantage plan. You can switch to a different Medicare Advantage plan or return to Original Medicare and enroll in a Part D plan.
  2. Special Enrollment Periods (SEPs): SEPs are triggered by specific life events. Here are some common SEPs:
    • Moving: If you move out of your plan’s service area, you can switch plans.
    • Loss of Coverage: If you lose other creditable coverage, such as employer-sponsored insurance, you qualify for a SEP to enroll in Medicare or make changes.
    • Qualifying for Extra Help: If you qualify for Extra Help with prescription drug costs, you may be eligible for a SEP.
    • Other Circumstances: Certain life events, like becoming eligible for Medicaid, can qualify you for a SEP.
  3. Medicare General Enrollment Period (GEP): If you didn’t sign up for Medicare Part A or Part B when you were first eligible, you can enroll during the GEP from January 1 to March 31 each year. Your coverage will start on July 1, and you may face a late enrollment penalty.

Example Scenario: Using the MA OEP

Let’s consider an example to illustrate how you can use the MA OEP:

Case Study: Tom’s Plan Change

Tom is enrolled in a Medicare Advantage plan but realizes after the AEP that the plan doesn’t meet his needs. Here’s what he can do:

  1. Medicare Advantage Open Enrollment Period (MA OEP): Tom can make a one-time change between January 1 and March 31.
  2. Review Options: Tom reviews other Medicare Advantage plans and finds one that offers better coverage for his needs.
  3. Switch Plans: Tom switches to the new Medicare Advantage plan during the MA OEP. His new coverage starts the first of the month after the plan receives his request.

Example Scenario: Using a SEP

Here’s an example of using a SEP:

Case Study: Sarah’s SEP Enrollment

Sarah missed the AEP but recently moved to a new state. Here’s what she can do:

  1. Triggering Event: Sarah’s move qualifies her for a SEP to make changes to her Medicare coverage.
  2. Review Options: Sarah reviews her Medicare Advantage and Part D plan options in her new state.
  3. Enroll in New Plan: Sarah enrolls in a new Medicare Advantage plan and Part D plan during her SEP. Her new coverage starts the first of the month after the plan receives her request.

Tips for Avoiding Missing the AEP Next Year

To avoid missing the AEP in the future, consider these tips:

  1. Set Reminders: Mark your calendar with the AEP dates (October 15 to December 7) and set reminders to review your Medicare coverage.
  2. Review Coverage Annually: Take the time to review your current coverage and any changes to your health needs or medications each year before the AEP.
  3. Seek Assistance: If you’re unsure about your options or need help reviewing plans, consider working with a licensed insurance agent or using resources like the State Health Insurance Assistance Program (SHIP).

Conclusion

Missing the Medicare Annual Enrollment Period doesn’t mean you’re out of options. By understanding the available enrollment periods and taking advantage of SEPs, you can make necessary changes to your coverage. Planning ahead and staying informed can help you avoid missing important deadlines in the future and ensure you have the coverage you need.

Free Medicare Consultation

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If you’re looking for this kind of insurance agent, I’ve got the perfect person: my wife, Niki. The quality of the service I put my name behind means everything to me, and frankly, she’s doing incredible work helping people.

Her agency can assist clients in all but a handful of states, which can be found at BrickhouseAgency.com.

With almost ten years of experience as an independent insurance agent, she embodies the expertise and values I advocate. Niki heads the Brickhouse Agency – a boutique insurance firm. Representing only trusted and fully vetted carriers, her team provides guidance on Medicare insurance options. She also donates 10% of her firm’s annual net profit to charity.

To discuss your Medicare needs or upcoming enrollment, you can:

About the Author

Matt Feret is the author of the Prepare for Social Security – The Insider’s Guide and the Prepare for Medicare – The Insider’s Guide book series and launched PrepareforSocialSecurity.com and PrepareforMedicare.com to help people get objective answers to questions about Social Security and Medicare. Matt is also the host of The Matt Feret Show. He has held leadership roles at numerous Fortune 500 Medicare health insurers in sales, marketing, operations, product development, and strategy for over two decades.