What to Do if You Missed the Annual Enrollment Period (AEP)
Missing the Annual Enrollment Period (AEP) can feel like a setback, but don’t worry—there are still options to get the Medicare coverage you need. In this guide, we’ll explore Special Enrollment Periods (SEPs) and other opportunities to make changes to your Medicare plan.
What Is the Annual Enrollment Period (AEP)
The AEP runs from October 15 to December 7 each year. During this time, Medicare beneficiaries can:
- Switch from Original Medicare to a Medicare Advantage plan (Part C).
- Change Medicare Advantage plans.
- Enroll in or change a Part D prescription drug plan.
- Return to Original Medicare from a Medicare Advantage plan.
If you missed this window, you may have to wait until the next AEP to make changes. However, certain situations allow for exceptions through Special Enrollment Periods.
Special Enrollment Periods (SEPs): A Lifeline After AEP
Special Enrollment Periods are specific times outside of AEP when you can enroll in or change Medicare plans due to qualifying life events. Here are some common scenarios that may make you eligible:
- Changing Your Residence
- You move to a new service area where your current plan isn’t available.
- You move back to the U.S. after living abroad.
- You leave or move into a skilled nursing facility or long-term care hospital.
- Losing Coverage
- You lose employer-sponsored health insurance.
- Your current plan ends its contract with Medicare.
- Other Life Changes
- You gain or lose eligibility for Medicaid or a Medicare Savings Program.
- You qualify for Extra Help with Medicare prescription drug costs.
- You experience an exceptional circumstance as determined by Medicare.
- To take advantage of an SEP, you’ll typically have 2 months from the qualifying event to make changes to your Medicare coverage.
Medicare Advantage Open Enrollment Period (MA-OEP)
If you’re already enrolled in a Medicare Advantage plan, you can make changes during the Medicare Advantage Open Enrollment Period, which runs from January 1 to March 31. This period allows you to:
- Switch to a different Medicare Advantage plan.
- Return to Original Medicare and add a Part D plan.
- This option is only available to those currently enrolled in a Medicare Advantage plan.
Other Options If You Missed AEP
- 5-Star Special Enrollment Period
Medicare uses a star rating system to evaluate the quality of Medicare Advantage and Part D plans. If a 5-star plan is available in your area, you can switch to it at any time between December 8 and November 30 of the following year.
- Medigap Open Enrollment
If you want to purchase a Medigap (Medicare Supplement Insurance) policy, you may be eligible for a 6-month Medigap Open Enrollment Period that begins when you’re first enrolled in Medicare Part B and are 65 or older. Outside of this window, you may still apply but could face medical underwriting.
- State-Specific Programs
Some states offer additional enrollment opportunities or programs to help Medicare beneficiaries. Check with your state’s Department of Insurance for more information.
Steps to Take Right Now
If you missed AEP and think you might qualify for an SEP or other enrollment period, follow these steps:
- Review Your Current Coverage
- Understand what your current Medicare plan covers and where it falls short.
- Identify Your Eligibility
- Determine if you qualify for an SEP based on life events or other circumstances.
- Contact Medicare or an Agent
- Reach out to Medicare at 1-800-MEDICARE or consult with a licensed Medicare agent to explore your options.
- Act Quickly
- SEPs have time limits, so act promptly to avoid missing another opportunity.
Need Help Navigating Medicare Enrollment?
Missing AEP doesn’t mean you’re out of options. Our experienced agents are here to help you understand your eligibility and guide you toward the best solution for your needs.
Contact us today for personalized assistance and make sure your health care needs are covered.
