Medicare Annual Enrollment Period (AEP)

When it happens: October 15 – December 7 each year
When changes begin: January 1 of the next year

Heads-up: Medicare Supplement (Medigap) policies can be shopped and changed any time of the year. AEP doesn’t govern Medigap.

Switch coverage types: Move between Original Medicare (Parts A & B) and Medicare Advantage (Part C).
Pick a new Medicare Advantage plan: Change from your current MA plan to another (with or without drug coverage).
Adjust Part D drug coverage: Enroll in, change, or drop a Part D plan.

Why AEP is important

Your situation: New conditions, medications, or doctors can change what plan “best fit” your needs
Plans change too: Premiums, deductibles, networks, and formularies commonly shift from year to year
Primary yearly window: For most people, AEP is the only opportunity to change medical and drug coverage for the coming year.
Remember: Medigap is reviewable year-round, separate from AEP. Medicare Supplements (Medigap) can be reviewed anytime.

Original Medicare: Part A (hospital) + Part B (medical). Optional Part D for drugs and optional Medigap to reduce cost-sharing.
Medicare Advantage (Part C): Private, bundled plans that include Parts A/B and often Part D, plus extras (e.g., dental/vision/hearing).
Part D: Standalone drug coverage for Original Medicare or embedded within many MA plans (MAPD).
Formulary: A plan’s covered drug list with tiers that drive copays. Plans can change these from year to year
MOOP: Maximum out-of-pocket limit for A/B services in MA plans (doesn’t include Part D). The most money you could be out in a year.

MA Open Enrollment Period (OEP): Jan 1 – Mar 31. If you’re in an MA plan on Jan 1, you may switch to another MA plan or drop MA for Original Medicare (and add Part D). You can’t switch standalone Part D unless leaving MA.
Initial Enrollment Period (IEP): Seven-month window around your first Medicare eligibility.
General Enrollment Period (GEP): Jan 1 – Mar 31 if you missed signing up for Part B; coverage starts later.
Special Enrollment Periods (SEPs): Life events like moving, losing other coverage, qualifying for Extra Help/Medicaid, or the 5-star plan option are examples that would allow you to make changes outside of the AEP window (October 15 – December 7)

Timing: Compare and apply whenever you want—not tied to AEP.
Underwriting: Outside guaranteed-issue periods, health questions can affect acceptance and price.
Compatibility: Works only with Original Medicare. If you have a Medicare Advantage Plan you do NOT need a Medigap plan.

Premiums: Plan premium plus Part B, Part D, and any Medigap premium.
Your Costs: Deductibles, copays, and coinsurance for visits, stays, therapy, and Durable Medical Equipment (DME).
MOOP (MA only): Your maximum annual exposure for A/B services.
Drugs: Formulary placement, tiers, preferred pharmacies, and any authorizations or step therapy.
Extras: Medicare Advantage Plans – Dental/vision/hearing, OTC allowances, fitness benefits, Part B givebacks, transportation.

Medicare Advantage: Provider networks apply—confirm doctors, facilities, and pharmacies are in-network/preferred.
Original Medicare: Broad national acceptance for A/B; Medigap helps control out-of-pocket costs. Can see ANY provider that accepts Medicare.
Travel considerations: MA may limit routine out-of-area care; Original + Medigap often provides easier nationwide usage.

Check your meds: Verify inclusion on the formulary, tier level, and any limits or approvals.
Pharmacy strategy: Using a preferred pharmacy may significantly reduce costs.
Insulin & vaccines: Many plans include enhanced insulin pricing and $0 vaccine coverage.

Part B late penalty: Lasting surcharge if you delay without credible coverage.
Part D late penalty: Permanent surcharge if you go 63+ days without credible drug coverage after becoming eligible.

Define must-haves, What is important to you: Doctors, hospitals, medications, budget, and desired extras.
Total projected cost: Premiums + cost-sharing + MOOP + drug expenses.
Access check: Confirm provider networks and preferred pharmacies. This is important if you have a Medicare Advantage Plan (MA).
Trade-offs: Original + Medigap (flexibility/predictable costs) vs MA (lower premiums/extras, managed networks).
Quality & fine print: Consider Star Ratings and benefit details.

Drug costs changes: Look for plans with better formulary placement or preferred pharmacy pricing.
Provider left your MA network: Consider another MA plan or move to Original + Medigap.
You frequently travel: Original + Medigap often simplifies out-of-state care; check MA PPO flexibility.
Healthy and value extras: A low-premium MA plan with attractive extras may fit—still review MOOP and network.
Prefer predictability: Original + a strong Medigap plan can reduce surprise bills (in exchange for monthly premiums).

Extra Help (Part D subsidy): May reduce premiums and drug costs if you qualify.
Medicaid & D-SNPs: Coordinated benefits for dual-eligible members.
5-star SEP: If a 5-star plan is available locally, you may switch once outside AEP.

Medicare will NOT call you or mail you a letter requesting you to call them.
Don’t share Medicare or Social Security numbers unless you’re certain who’s asking.