The Medicare Annual Enrollment Period (AEP) is a set period of time where you can change your Medicare benefits. Every year, the AEP lasts from October 15 to December 7. If you didn’t sign up for a Medicare Advantage plan or a Medicare prescription drug plan when you first became eligible for Medicare (during your Initial Enrollment Period), the AEP is usually your chance to do so, unless you apply for a Special Election Period (SEP). It also allows you to make any changes you need to tailor your Medicare coverage to your specific needs.
If you are eligible or already enrolled in any Medicare product you can use the AEP to move to a different Medicare plan, sign up for an entirely new plan, or drop out of a plan. This includes the ability to move from Original Medicare to Medicare Advantage, switch between different Medicare Advantage plans, and sign up for or change Medicare prescription drug coverage.
Your AEP Options
During the Medicare AEP, you can move from Original Medicare (Parts A and B) to Medicare Advantage (Part C), or vice versa, if you already have Medicare. However, if you want to switch, you may also have to make some other choices. Depending on what kind of plan you’re switching to and from, you’ll have to make different decisions.
In this case, you have Original Medicare and want to move to a Medicare Advantage plan. You may also have a separate Part D plan for prescription drugs. Most Medicare Advantage plans include everything that you need. They pay for your Medicare Part A and Part B benefits, as well as Part D prescription drugs and other health services and things that Original Medicare doesn’t cover. Some of these other things are dental, vision, and hearing care, as well as gym memberships. There is also an annual out-of-pocket limit on Medicare Advantage plans to keep you from paying too much.
During the AEP you can move from Original Medicare to a Medicare Advantage plan. Depending on the Medicare Advantage plan you choose, you may no longer need a separate Part D plan if you already have one. With Medicare Advantage, you usually don’t need a separate Part D prescription drug plan because drug coverage is built in.
If you switch to a Medicare Advantage plan, the plan will work with Medicare to move your benefits over. You don’t have to get in touch with Medicare on your own. On January 1, your new plan will start to cover you. If you have a stand-alone Part D prescription drug plan or another private Medicare plan, you’ll need to call the plan provider directly to drop out. Just call the number on the back of your member ID card. During the Medicare Advantage Open Enrollment Period, which runs from January 1 to March 31, you can choose a different Medicare Advantage plan or switch back to Original Medicare.
Medicare Advantage To Original Medicare
Original Medicare only has Part A (coverage for hospital stays) and Part B (coverage for medical care). It doesn’t give you some of the things your Medicare Advantage plan might have, like coverage for prescription drugs, dental, vision, or fitness. Original Medicare also doesn’t have an annual out-of-pocket cap, so there is no built-in financial protection.
If you still want these things, you will need to buy extra coverage. For example, if you want coverage for prescription drugs, you will now have to find a stand-alone Part D plan and sign up for it. If you decide you need more coverage, you will need to choose a Medicare Supplement Plan and sign up directly with the plan provider. To make the switch to Original Medicare, you will need to call your Medicare Advantage plan provider or Medicare directly.
Medicare advantage plans are pretty comprehensive, but there are still times you may want to switch to a different plan. Such as:
Moving to a plan that offers drug coverage
Moving to a plan without drug coverage
Switching to a plan that has dental or vision coverage
Aside from the AEP there are other times you can change your Medicare Advantage plan. During the Medicare Advantage open enrollment period, which runs from January 1 to March 31 every year, you can make changes to your plan at any time. The changes you make will go into action on the first of the month after you make them. You can also change your Medicare Advantage plan during a Special Enrollment Period if you have a big change in your life. Medicare may give you a special enrollment period if you move to a new place, if your coverage choices change, or if certain other things happen in your life.
You can apply for a Medicare Supplement Plan at any time of the year, not just during the AEP. However, unlike Part D and Medicare Advantage plans, Medicare Supplement Plans don’t have to offer a yearly enrollment period like Part D and Medicare Advantage plans do. If you apply for a Medicare Supplement Plan after your six-month initial enrollment time has ended, the insurer is likely to use a process called “medical underwriting” to decide if you are eligible and how much you will have to pay. Some states have passed laws that make it easier for seniors to switch from one Medicare Supplement Plan to another by applying birthday rules or guaranteed issue rights. Both allow a specific amount of time where you can change your Medicare Supplement Plan without going through underwriting.
Guaranteed Issue Rights
New York and Connecticut – Medicare Supplement Plans are guaranteed issue all year.
Massachusetts – There is a 2 month period every year between February and March where plans are guaranteed issue
Maine – Participants can move to a different Medicare Supplement plan with the same or less benefits at any time during the year, and all carriers must set aside one month each year when Medicare Supplement Plan A is guaranteed to be available to all participants.
Missouri – There is an Anniversary Guaranteed Issue Period. Anyone with a Medicare Supplement plan has 60 days around the anniversary of their plan each year to switch to the same plan from a different insurance company.
Birthday Rules
California – The rule goes into effect 30 days before their birthday and stays in place for 60 days after. During this time, customers in The Golden State can switch to any plan with the insurance company of their choice that has the same or less benefits.
Oregon – The birthday rule starts on your birthday and lasts for 30 days after that. This gives you 31 days to change plans. It works like California’s and lets customers switch to any insurance company or plan with the same or less benefits.
Idaho – This rule goes into effect on your birthday and lasts for 63 days. You will be able to sign up for any plan with the same or less benefits. Also, the plan could be with any provider.
Illinois – This birthday rule only applies to people who are 65 to 75 years old. During this time, you can switch plans with your current insurance company. But the benefits of your new plan can’t be better than those of your old plan. This open registration period starts on your birthday and goes on for 45 days.
Louisiana – The time for the birthday rule starts 30 days before your birthday and ends 63 days after it. So, you have 93 days to change the plan you have now. During this time, you can switch to a policy with the same or less benefits through your present provider.
Maryland – The birthday rule for Medicare Supplement starts on your birthday and ends 30 days after that. Giving residents 31 days to sign up for a plan with the same or less worth.
Nevada – For at least 61 days, you can make changes to your plan. This window opens on the first of your birthday month. You can switch carriers or plans during this time, but the benefits of the new plan must be the same or less than what you get from your present plan.
Oklahoma – The 60-day window for the birthday rule starts on your birthday. During the 60 days, you can change your plan or provider. However, you can only switch to a plan with the same or less value than the one you have now.
Need Help?
Medicare is great, but sometimes it can be hard to understand. Even after you sign up during the AEP, you’ll still have to make some decisions about your health care. Don’t worry about asking questions. Talk to an EZ person who can tell you what you need to do to sign up and explain everything to you. EZ can help you sign up, buy a Medicare Supplement Plan, or just think about your choices. Our insurance brokers work with the best firms in the country. You can get a free review of all the plans in your area from them. We’ll talk with you about your medical and financial needs and help you find a plan that meets them all. Call one of our certified agents at 877-670-3602 to get started.
