The Medicare Annual Enrollment Period—or Medicare AEP for short—occurs during the fall between October 15 and December 7. The AEP is when you can change from Original Medicare (Parts A and B) to Medicare Advantage (MA) and vice versa, add a Medicare Part D Prescription Drug Plan (PDP) to your Original Medicare benefits, or switch from one MA or PDP plan to another.
Different Names for Medicare AEP
Before we continue, let’s go over some of the different names for the Medicare Annual Enrollment Period. They are:
- the Annual Election Period (AEP),
- the Medicare Open Enrollment Period (OEP), and
- the Medicare Fall Open Enrollment.
Whenever you see these various names, they are referring to the October 15 to December 7 Medicare Open Enrollment date.
Why Join a Medicare Advantage or Part D Plan During AEP?
There are many reasons why you would want to join a Medicare Advantage (MA) or Medicare Part D drug plan during the Medicare Annual Enrollment Period (AEP). Some of these are:
- MA includes Original Medicare plus more. MA plans must include Original Medicare Part A and Part B benefits. This makes MA plans a convenient way to get your Part A hospital insurance, Part B medical insurance, and extra health benefits that can help maintain your health.
- Original Medicare doesn’t cover every medical service. Medical services—such as routine care for dental, vision, and hearing—are not covered under Original Medicare. But you can access these health benefits by enrolling in MA. Being able to switch from Original Medicare to MA is one of the main differences between Medicare AEP and the Medicare General Enrollment Period (GEP). Because you can switch to an MA plan (or change your current MA plan) during AEP, this time period is also the Medicare Advantage Open Enrollment.
- MA plans limit your out-of-pocket spending. Unlike Original Medicare, which doesn’t have a limit on how much your out-of-pocket costs such as coinsurance and copays can add up to, MA plans have a yearly out-of-pocket limit for covered Part A and Part B medical expenses. MA plans pay for all your covered expenses after you’ve reached the plan’s yearly limit.
- Original Medicare doesn’t include prescription drug benefits. You don’t get prescription drug coverage automatically when you enroll in Medicare. To get coverage for your medications, you can join a standalone Medicare Part D Prescription Drug Plan (PDP) to add drug benefits to your Original Medicare coverage. Or, you can switch from Original Medicare to a Medicare Advantage Prescription Drug Plan (MAPD) during AEP, which is the same time as the Medicare Part D Enrollment Period.
Note: Both MA and Medicare Part D Prescription Drug Plans (PDPs) are only available through private insurance companies that contract with Medicare.
Why Review Your Medicare Coverage During AEP
Whether you’re currently getting your Medicare benefits through Original Medicare or you’re enrolled in a Medicare Advantage (MA) or Medicare Part D drug plan, it’s important that you review your Medicare plan options during AEP. Some reasons why the October 15 to December 7 Medicare open enrollment date is a great time to re-evaluate your Medicare choices are:
- To make sure your coverage meets your current healthcare needs: If your health has changed and you’re not sure if your plan adequately meets you needs, a licensed insurance agent can help by comparing options such as an all-in-one MA plan that includes Original Medicare plus additional health benefits like prescription drug, dental, vision, and hearing coverage, which can help fill the gaps in your current plan.
- To make sure your current medications are covered: Did you know that drugs on a plan’s formulary can change every year? Not only that, the price you pay for your medicines can be different from plan to plan because some plans are able to negotiate higher discounts with certain pharmacies. A licensed insurance agent can compare your medications among different Medicare prescription drug plans to find the right one for you. They can also check to see if you qualify for Extra Help from Medicare to help pay your prescription drug costs.
- To see if you can better manage your out-of-pocket medical expenses: You can work with an agent to explore options that may help you save money, such as a zero-premium Medicare Advantage plan or a Medicare Supplemental plan that offers more flexibility in paying for Medicare’s out-of-pocket expenses, such as deductibles, copayments, and coinsurance.
- To make sure you have access to your preferred healthcare providers: An agent can compare MA plans in your area to find the best option for you that uses your favorite doctors, specialists, healthcare facilities, and pharmacies.
Medicare AEP vs. Medicare General Enrollment Period: What’s the Difference?
Did you know there are differences in the Medicare Annual Enrollment Period (AEP) and the Medicare General Enrollment Period? These are two separate time periods that have different Medicare Open Enrollment dates. Knowing the facts about these Medicare Open Enrollment periods and what time of year they occur can help you make the right decision when choosing Medicare coverage. Unlike Medicare AEP, the Medicare General Enrollment Period (GEP) takes place annually from January 1 to March 31. This is the time of year when you can join Original Medicare Parts A and B for the first time if you didn’t sign up for Medicare benefits when you were first eligible during your Initial Enrollment Period (IEP).
An easy way to remember Medicare AEP vs. Medicare General Enrollment Period is:
- The AEP is when you can change your existing Medicare coverage.
- The GEP is when you can sign up for Medicare Part A and/or Part B for the first time.
Getting Medicare for the First Time During the GEP
If you choose to delay enrollment in Medicare Part A, Part B, or both during your Initial Enrollment Period (IEP), you get another chance to enroll during the Medicare General Enrollment Period (GEP) from January 1 to March 31. When you sign up for Medicare during the GEP, you may have to pay late-enrollment penalties. The penalty for Medicare Part A applies if you don’t quality for premium-free Part A benefits and didn’t enroll when you were first eligible. If you get Medicare Part B during the GEP, you may pay a late-enrollment penalty for the entire time you have Part B.
Again, it’s important to remember that the GEP only allows you to enroll in Medicare Parts A and B. You can’t switch from Original Medicare to Medicare Advantage (MA) or vice versa, or change your MA or Medicare Part D plan during the GEP.
Best Time to Get Medicare to Avoid Late-Enrollment Penalties
The best time to sign up for Medicare benefits to avoid paying higher premiums because of late-enrollment penalties is during your Initial Enrollment Period (IEP). This is the seven-month period surrounding your 65th birthday month. But if you or your spouse are still working or you have group health insurance through your current job, you can delay your enrollment. If this applies to you, you will get a Special Enrollment Period (SEP) to sign up for Medicare when you or your spouse stops working or your employer-based health coverage ends—whichever happens first. There is usually no late-enrollment penalty for getting Medicare when you qualify for an SEP.
HealthMarkets licensed insurance agents can help you narrow your Medicare plan choices to find the best fit for your needs and budget. Our service is at no cost to you, and you’re never under any obligation to enroll. Get help comparing your coverage options for Medicare Annual Enrollment Period vs. Medicare General Enrollment Period. Call us at (800) 488-7621 or find an agent in your area today!