The Medicare Annual Enrollment Period (AEP) is the most significant window of the year for Medicare beneficiaries to evaluate and modify their coverage. Taking place from October 15 through December 7 each year, the AEP lets you make changes that go into effect on January 1.
What Changes Are Allowed During the AEP
During the Annual Enrollment Period, you can:
- Move from Original Medicare to a Medicare Advantage plan
- Return from Medicare Advantage to Original Medicare
- Switch your Medicare Advantage plan to a different option
- Enroll in a Part D prescription drug plan
- Change your Part D plan to a different one
- Cancel Part D coverage (though doing so may trigger a late enrollment penalty if you do not have other creditable drug coverage)
Why You Should Review Your Plan Each Year
Medicare plans may alter their benefits, costs, formularies, and provider networks annually. Even if you are satisfied with your current plan, upcoming changes could have an impact on you:
- Higher premiums could raise the cost of your plan
- Formulary adjustments might shift your medications to a more expensive tier or remove them altogether
- Provider network updates may mean your preferred doctors or hospitals are no longer included
- Reduced benefits could eliminate extras you depend on
Reviewing your plan's Annual Notice of Change (ANOC), which arrives in the mail each September, is the best way to identify these changes before the AEP starts.
How to Evaluate Your Options
Use these steps to compare plans effectively:
1. Determine Your Priorities
Figure out what matters most to you:
- Specific doctors and hospitals
- Medications you take on a regular basis
- Monthly premium budget
- Preferred coverage type (Original Medicare vs. Medicare Advantage)
2. Use the Medicare Plan Finder
Go to Medicare.gov and input your medications, pharmacies, and providers to see how various plans stack up on cost and coverage.
3. Look at Total Costs
Do not focus solely on the monthly premium. Also consider:
- Annual deductibles
- Copays and coinsurance for services you use often
- Out-of-pocket maximums
- Prescription drug expenses over the course of the year
4. Review Star Ratings
Plans with higher star ratings generally deliver better care and customer service. Those rated four stars or above frequently offer enhanced benefits.
Common AEP Mistakes to Watch Out For
- Skipping your plan review entirely. Even if you intend to stay, look for changes that could raise your costs.
- Selecting a plan based only on premium. A $0 premium plan may carry higher out-of-pocket costs than one with a modest premium.
- Overlooking the formulary. Confirm that your medications are covered at a reasonable cost.
- Missing the deadline. The AEP closes on December 7. If you let it pass, your options may be limited until the next enrollment period.
After the AEP: Medicare Advantage Open Enrollment
If you are in a Medicare Advantage plan on January 1, you get an additional window during the Medicare Advantage Open Enrollment Period (January 1 through March 31) to:
- Switch to a different Medicare Advantage plan
- Leave your Medicare Advantage plan and go back to Original Medicare (and enroll in a standalone Part D plan)
This period serves as a safety net if you are unhappy with the plan you selected during the AEP.
Where to Get Free Help
Free assistance is available through your State Health Insurance Assistance Program (SHIP). Trained counselors can help you compare plans and make well-informed decisions at no charge. Reach SHIP at 1-877-839-2675 or visit shiphelp.org.