Every year, millions of Americans with Medicare have an important opportunity to review and adjust their healthcare coverage during the Annual Election Period (AEP). This window, which runs from October 15 through December 7, allows beneficiaries to make changes to their Medicare plans for the upcoming year. Whether you want to switch your Medicare Advantage plan, change prescription drug coverage, or return to Original Medicare, AEP is the time to do so.
For those currently on Medicare or approaching eligibility, understanding how the Annual Election Period works is extremely important. In this article, we’ll address some of the most frequently asked questions that should help you breeze through AEP!
What Is Medicare’s Annual Election Period?
The Annual Election Period (also known as the Annual Enrollment Period or AEP) is a designated time each year when Medicare beneficiaries can change their Medicare plans. It begins on October 15 and ends on December 7. During this period, individuals with Medicare have the option to evaluate their current coverage and decide if they need to make adjustments for the upcoming year.
AEP is open to anyone already enrolled in Medicare Parts A and B. Whether you have Original Medicare, a Medicare Advantage plan, or a standalone prescription drug plan (Part D), this is the time to review your current plan and decide if it’s still the best fit for your healthcare and financial needs. This opportunity is available every year, giving you the flexibility to adapt your coverage to any changes in your health or personal circumstances.
What Changes Can You Make During the AEP?
The Annual Election Period offers several options for Medicare beneficiaries to adjust their coverage. Here are the main changes you can make:
Switching Medicare Advantage Plans
If you’re enrolled in a Medicare Advantage (Part C) plan, you can switch to a different Medicare Advantage plan during AEP. This includes changing from a plan with drug coverage to one without, or vice versa, based on your healthcare needs.
Switching from Medicare Advantage to Original Medicare
If you’re currently in a Medicare Advantage plan but want to go back to Original Medicare (Parts A and B), you can do so during this period. Once you switch to Original Medicare, you can also add a Medicare Part D plan to cover prescription drugs.
Switching Prescription Drug Plans (Part D)
If you have a standalone Medicare Part D prescription drug plan, AEP allows you to switch to a different plan. Since drug formularies, costs, and coverage can change from year to year, this is a good time to make sure your medications are still covered by your plan.
Enrolling in Medicare Advantage or Part D for the First Time
If you didn’t enroll in a Medicare Advantage or Part D plan when you were first eligible, AEP provides an opportunity to sign up. This is especially important if you want more comprehensive coverage beyond what Original Medicare provides.
Why Is AEP Important?
The Annual Election Period is a valuable opportunity for Medicare beneficiaries to ensure their healthcare coverage is meeting their needs. There are a few reasons why this matters.
First, it’s an opportunity to optimize your coverage. Your healthcare needs can change over time, and so can the benefits and costs of Medicare plans. The AEP allows you to review your current plan and compare it with others to determine if it’s still the best option. Whether it’s because of new health conditions, changes in medication, or simply wanting different benefits, AEP gives you the chance to tailor your coverage to your specific situation.
Second, there is the potential to save money! Medicare plans can vary significantly in terms of premiums, deductibles, copayments, and drug costs. By exploring your options during AEP, you may find a plan that provides better coverage for a lower price. This could mean substantial savings on out-of-pocket expenses, especially if your current plan’s costs have increased.
Lastly, staying in a plan that no longer fits your needs could result in unexpected costs or coverage limitations. For example, if your medications are no longer covered under your current Part D plan or if your doctor is no longer in your Medicare Advantage network, you may face higher out-of-pocket expenses. AEP allows you to make adjustments and avoid these gaps in coverage for the coming year.
What Are the Deadlines for AEP?
The Annual Election Period follows a specific timeline, and it’s important to know the key dates so you don’t miss your chance to make changes.
Starting on October 15, you can begin reviewing your current Medicare plan, comparing new options, and deciding if you want to switch or make adjustments. The Annual Election Period officially ends on December 7. This is the final day to submit any changes to your plan for the upcoming year. After this deadline, you will generally be locked into your selected coverage until the next AEP, unless you qualify for a Special Enrollment Period.
Any changes made during the AEP will take effect on January 1 of the following year. Whether you’ve switched Medicare Advantage plans, changed your Part D prescription drug plan, or returned to Original Medicare, your new coverage will begin at the start of the new year.
It’s important to review your options and finalize any changes before December 7 to avoid missing the deadline. If no changes are made, your current plan will automatically renew for the next year, but this could result in unwanted costs or reduced coverage if the plan has changed.
How Do I Enroll or Make Changes During AEP?
There are several ways to enroll in a new plan or make changes to your existing Medicare coverage during the Annual Election Period.
One of the easiest ways to compare plans and make changes is through Medicare.gov. The website allows you to enter your information, review available plans in your area, and enroll online. This option is convenient and gives you the ability to view side-by-side comparisons of plans, costs, and coverage details. However, while this is a great way to begin your research, you may not have access to as much information as an independent advisor.
Many Medicare beneficiaries find it helpful to work with a licensed insurance agent or broker to get personalized advice. A Medicare broker, such as Carolina Senior Benefits, can help you understand your options, compare plans, and ensure you’re choosing the best coverage for your needs. Since agents are familiar with the latest plan details and costs, they can provide expert recommendations based on your specific healthcare situation. Importantly, there is no cost to work with a broker, and they can handle much of the enrollment process for you.
What Should I Consider When Reviewing Plans During the AEP?
Choosing the right Medicare plan during the Annual Election Period requires careful consideration.
Your healthcare needs may change from year to year, so it’s important to assess whether your current plan still provides the coverage you require. If you’ve developed new health conditions or require more specialized care, you may need a plan with different benefits. Consider factors such as access to specialists, hospitals, or particular treatments that you may need in the upcoming year.
When comparing plans, it’s important to look beyond the monthly premium. Review each plan’s total costs, including deductibles, copayments, and out-of-pocket maximums. Medicare Advantage and Part D plans can vary significantly in terms of these expenses, so make sure to evaluate how much you’ll pay for doctor visits, hospital stays, and prescription medications.
If you’re considering a Medicare Advantage plan, you’ll need to check whether your preferred doctors, hospitals, and other healthcare providers are part of the plan’s network. Medicare Advantage plans often have specific networks of providers, and going out-of-network could result in higher costs or limited access to care. Make sure the plan you choose includes the healthcare professionals and facilities you want to continue using.
For those with a Part D prescription drug plan or a Medicare Advantage plan that includes drug coverage, it’s important to review the plan’s formulary—the list of medications covered by the plan. Formularies can change each year, and drugs that were covered previously may not be included in the coming year. Check to ensure your current medications are covered and that the costs fit within your budget.
Lastly, some Medicare Advantage plans offer additional benefits that Original Medicare doesn’t cover, such as dental, vision, hearing, or fitness programs. If these services are important to you, consider whether switching to a plan with these extras makes sense for your overall health and well-being.
What If I Miss the AEP Deadline?
If you miss the Annual Election Period deadline on December 7, you still have a few options to make changes to your Medicare coverage, but they are limited.
The General Enrollment Period runs from January 1 to March 31 each year. However, this period only applies to those who didn’t sign up for Medicare Part A or Part B when they were first eligible. If you enroll during the GEP, your coverage will start on the first day of the month after you enroll, and you may face late enrollment penalties for Parts A and B. The GEP does not allow you to make changes to Medicare Advantage or Part D plans.
If you’re already enrolled in a Medicare Advantage plan, you have another opportunity to make changes during the Medicare Advantage Open Enrollment Period from January 1 to March 31. (Yes, this enrollment period runs alongside the GEP.) During this time, you can switch to a different Medicare Advantage plan or return to Original Medicare and enroll in a standalone Part D plan. Keep in mind that this period is only available to those with Medicare Advantage, and you can only make one change.
In certain situations, you may qualify for a Special Enrollment Period (SEP), which allows you to make changes outside of the usual AEP. SEPs are triggered by specific life events, such as:
- Moving out of your plan’s service area.
- Losing other health coverage, such as employer or union coverage.
- Qualifying for Medicaid or receiving Extra Help for prescription drug costs.
- Moving into or out of a skilled nursing facility or long-term care hospital.
If you qualify for an SEP, you can make changes to your Medicare Advantage or Part D plan based on your circumstances, usually within a two-month window after the triggering event.
Common Misconceptions About AEP
There are several misconceptions about Medicare’s Annual Election Period that can lead to confusion or missed opportunities. Let’s clear up a few of the most common ones.
“I Don’t Need to Review My Plan If I’m Happy With It”
Even if you’re satisfied with your current plan, it’s still important to review it each year during AEP. Plans can change from year to year—whether it’s increased premiums, adjustments to benefits, or changes to drug formularies. Additionally, your healthcare needs may have shifted, meaning your current plan might no longer be the most cost-effective or comprehensive option. Taking the time to compare your plan with other options can help ensure you’re still getting the best coverage.
“I Can Make Changes Anytime”
Many people mistakenly believe they can change their Medicare plan at any point throughout the year. In reality, you can only make changes to your Medicare Advantage or Part D plan during specific enrollment periods, such as AEP. Outside of these periods, you’re generally locked into your coverage unless you qualify for a Special Enrollment Period.
“Medicare Will Automatically Enroll Me in the Best Plan”
Medicare does not automatically switch you to a different plan based on what might be best for you. If you do nothing during AEP, your current plan will usually renew for the following year—whether or not it’s still the most suitable option for your needs. You must actively compare and select plans during the AEP if you want to make changes. It’s your responsibility to review your plan and decide if staying put or switching is in your best interest.
Take Action Now for Your Medicare Needs
AEP is in full swing and now is the time to assess your Medicare coverage and make any necessary changes. Your health and financial well-being depend on having the right plan in place, and with various options available, it’s essential to choose the one that best fits your needs.
At Carolina Senior Benefits, we’re here to help you navigate this important period. Our knowledgeable team can assist you in reviewing your current plan, comparing available options, and ensuring you have the coverage that suits your health requirements and budget.
Don’t wait until the last minute—take the proactive step of calling our office today to schedule a review of your Medicare plans. Together, we can ensure that you make informed decisions and secure the best possible healthcare coverage for the coming year. Your peace of mind starts with a simple phone call!
