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When is the annual Open Enrollment Period (AEP) for Medicare Part D plans?


The Medicare annual Open Enrollment Period is the same every year - and begins on October 15th and continues for seven (7) weeks through December 7th.

During the AEP, you can join, change, or drop your Medicare Part D prescription drug plan (PDP) or Medicare Advantage plan (like an HMO, PPO, HMO POS, or PFFS  plan) that includes prescription coverage (MAPD) or a Medicare Advantage plan without prescription coverage (MA).

The changes that you make to your Medicare plan coverage will  take effect on January 1st.

For example, if you decide to drop your Medicare Advantage plans during the AEP and join a stand-alone Part D drug plan, your new Medicare Part D  plan coverage will begin on January 1st - and you will be returned to your original Medicare Part A and Medicare Part B coverage.

You may hear different terms for the same enrollment period.

The popular name of the fall Medicare Open Enrollment Period has evolved over time and you may hear people say:
  • annual Open Enrollment Period or AEP (the term we use most often) or
  • the Annual Enrollment Period or
  • the Annual Coordinated Election Period or
  • the Annual Election Period.
All of these name describe the same annual Medicare Part D and Medicare Advantage plan enrollment period starting October 15th and continuing through December 7th.

The AEP vs. the MA-OEP

Please be sure to recognize the MA-OEP as the Medicare Advantage Open Enrollment Period - not to be confused with the AEP or Fall OEP.  The MA-OEP begins January 1st and continues through March 31st.  During the MA-OEP, you have one opportunity to change or drop your Medicare Advantage plan (MA/MAPD) coverage.

If you make changes to your Medicare Advantage plan during the MA-OEP, coverage for your new Medicare plan - (PDP) or Medicare Advantage plan (MA or MAPD) will begin the first day of the month after the change.

For example, if you decide to drop your Medicare Advantage plans on January 2nd, during the MA-OEP and join a stand-alone Medicare Part D prescription drug plan, your new Medicare Part D  plan coverage will begin on February 1st - and on February 1st, you will be returned to your original Medicare Part A and Medicare Part B coverage.

Reminder: Enrolling into a Medicare Part D or Medicare Advantage plan outside the AEP

Usually cannot change their Medicare plan coverage outside of the AEP or MA-OEP.  However, Medicare provides Special Enrollment Periods (SEP) allowing plan changes outside of the AEP or MA-OEP for people who experience certain changes in their life or meet certain requirements.

For example, if you move out of your Medicare plan's Service Area (the region or state or county or Zip Code), you will be granted an SEP to join a new Medicare Part D (or Medicare Advantage plan) in your new Service Area.

Also, people who move into, reside in, or move out of a nursing facility (SNF), long-term care facility (LTC), or assisted living facility will be granted an SEP to find a new Medicare Part D plan.

And Medicare beneficiaries who qualify for the Medicare Part D financial extra help program are granted a continuous SEP to change Medicare plans at any time throughout the plan year so that they are always receiving the most affordable prescription and healthcare coverage.

You can read more about Special Enrollment Periods here:
https://Q1FAQ.com/561.html

If you are granted a Special Enrollment Period and change Medicare plans outside of the AEP, your new Medicare Part D plan coverage will start (or have an effective date) on the first day of the next month after your enrolllment decision.

Example of an SEP for "moving to another Service Area"

You move from Florida to North Carolina in June (and North Carolina is no longer in your Medicare plan's Service Area).  You will be granted a Special Enrollment Period to join a new Part D plan (or Medicare Advantage plan) that is available in your new residence state of North Carolina (or the specific county where you live).  If you choose to enroll in a new Medicare plan in June, your new plan coverage begins on July 1st.

However, if you are enrolled in a Medicare Part D plan in Pennsylvania and move to West Virginia, you are not granted an SEP because Pennsylvania and West Virginia are in the same Medicare Part D plan region (CMS Region 6).  You can see how states across the country are organized into Medicare Part D plan regions here:  https://q1medicare.com/PartD-Medicare-PartD-Overview-byRegion.php





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Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.