The Medicare Annual Enrollment Period (AEP) is an important window for Medicare beneficiaries to review and make changes to their annual coverage. However, life can sometimes get busy, and you might find yourself wondering what to do if you miss the Medicare AEP.
Don’t worry – you’re not alone. Options are still available to ensure you have the coverage you need.
8 steps to take if you’ve missed the Medicare AEP
Step 1. Understand your options
Missing the Medicare AEP doesn’t mean you’re out of luck. There are still certain periods during which you can make changes to your Medicare coverage. Here are the most common:
- Medicare Advantage Open Enrollment Period (OEP): If you’re already enrolled in a Medicare Advantage plan and missed the AEP, you can make changes during OEP, which runs from January 1st to March 31st. During this period, you can switch to another Medicare Advantage plan or switch back to Original Medicare.
- General Enrollment Period (GEP): If you missed enrolling in Medicare Part A and/or Part B when you were first eligible, you can use the GEP. It also runs from January 1st to March 31st. Keep in mind that late enrollment penalties might apply, so it’s important to understand the potential costs.
Step 2. Evaluate your current coverage
Take some time to evaluate your current healthcare needs and coverage. Are your healthcare needs the same as they were during your last enrollment period? Have there been changes in your health condition, or are you taking new medications? This will help you decide whether your current plan still works for you or if you should explore other options.
Step 3. Research available plans
If you’ve missed the Medicare AEP, take time to research the available plans that suit your needs. Look into Medicare Advantage plans, Medicare Supplement plans (Medigap), and standalone prescription drug plans (Part D). Compare costs, coverage, networks, and any additional benefits that might be important to you.
Are you interested in the flexibility of a Medicare Advantage plan, or do you prefer the comprehensive coverage of Original Medicare with a Medigap plan? Research and compare the options available in your area to find the one that aligns with your healthcare preferences.
Step 4. Seek professional assistance
Making the right choices for your healthcare needs is sometimes a life-or-death decision, and Medicare can be confusing. But every person’s situation is different — as are Medicare plan costs, coverage gaps, and network limitations — so it’s okay to ask for help.
Consider reaching out to a licensed insurance agent or a Medicare counselor who can provide personalized guidance and help you navigate the options available in your area. At The Baldwin Group, our Medicare agents have seen countless scenarios and can offer help based on real-world experience. To gain confidence about your choices, connect with The Baldwin Group’s Medicare team today for help simplifying your decision-making process.
Step 5. Be prepared for changes
If you make changes during the Medicare Advantage OEP or the GEP, make sure you know the implications of your decisions. It might require adjusting to a new network of healthcare providers, reviewing prescription drug coverage and formularies, and calculating potential cost changes.
Be prepared to adjust to these changes and ensure that your new plan aligns with your medical needs and preferences — and your out-of-pocket budget.
Step 6. Consider Special Enrollment Periods (SEPs)
In certain situations, you might qualify for a Special Enrollment Period (SEP) even if you missed the Annual Enrollment Period. SEPs are triggered by life events, such as moving, losing employer coverage, or qualifying for Medicaid, allowing you to make changes to your Medicare coverage outside of the standard enrollment periods.
If you believe you qualify for a Special Enrollment Period, give us a call at (813) 939-5288 to learn more about your options and the required documentation you might need.
Step 7. Review your Medicare Advantage Disenrollment Period
Each year, from January 1 to February 14, there’s a Medicare Advantage Disenrollment Period (MADP). If you’re enrolled in a Medicare Advantage plan, this period allows you to drop your Medicare Advantage plan and return to Original Medicare. You can also join a standalone Part D prescription drug plan during this time.
These options could be particularly helpful if you’ve realized that your current Medicare Advantage plan doesn’t meet your needs — or if your health status has changed significantly after missing the AEP.
Step 8. Mark your calendar
While missing the Medicare AEP can lead to additional steps and potential changes, it’s a good reminder to mark your calendar for future Annual Enrollment Periods.
Typically, the Medicare AEP runs from October 15th to December 7th each year. Setting reminders and keeping track of important dates can help you avoid missing enrollment opportunities in the future.
Marking your calendar for the next AEP provides you with plenty of time to review your coverage, plot out necessary changes, and avoid the stress of rushing decisions. Being proactive about enrollment can save you time and help you avoid any future hassles.
What to do next
Missing the Medicare Annual Enrollment Period doesn’t mean you’re without options. Just take a moment to learn about other times to sign up, figure out what kind of coverage you really need, and don’t hesitate to ask for help. Being in the know and taking action will help make managing Medicare easier.
