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My new Medicare Part D coverage is much more expensive than last year. Can I still change to another Medicare Part D prescription drug plan after the AEP closes?

Category: Changing Medicare Part D Plans
Updated: Apr, 28 2023
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Maybe, depending on your situation.  Most people cannot change their Medicare Part D plan coverage after the December 7th Annual Enrollment Period (AEP) deadline.  However, if you qualify for a Special Enrollment Period (SEP), you can change your Medicare Part D or Medicare Advantage plan during the plan year and outside of the AEP.

You may qualify for a Special Enrollment Period for a number of reasons, some common examples include:
  • SEP for Moving to another area.
    If you move out of your Medicare plan’s Service Area - you will be granted an SEP to join a Medicare plan in your new Service Area.  (Your Medicare Part D plan's Service Area is a State or multi-State area - your Medicare Advantage plan's Service Area is a county, partial-county, or ZIP Code area).  For example, if you live in California and move to Florida, you would be granted an SEP to join a Medicare plan (Medicare Part D or Medicare Advantage plan) that is available in your county or ZIP Code region.  If you are enrolled in a Medicare Advantage plan while living in Saint Johns County, Florida and you move to Lake County, Florida - you will be allowed to join a Medicare Advantage plan that is available in Lake County.  But if you are enrolled in a Medicare Part D plan and you move to another Florida county, you will not qualify for an SEP since you still live within your Medicare plan's Service Area (the state of Florida).

  • SEP for entering or leaving a LTC facility.
    If you move into (or out of) a Long-Term Care (LTC) facility.

  • SEP if enrolled in a Sanctioned Medicare plan.
    If you are enrolled in a sanctioned Medicare plan (see SEP for sanctioned plans), you may qualify for an SEP. To learn more and see if you qualify for this particular SEP, you will need to contact Medicare at 1-800-633-4227.

  • SEP when you are no longer incarcerated.
    If you were incarcerated, you will be granted a Special Enrollment Period upon your release to join a Medicare plan in your new area of residence.



  • SEP if you are eligible for Extra-Help.
    If you are eligible for the low-income subsidy (LIS) or the Medicare Part D Extra-Help program, you can change your Medicare Part D prescription drug coverage once per quarter during the first nine months of the year (January through September).

  • SEP if you are enrolled in a Low-performing Medicare plan.
    If you are enrolled in a consistently low-performing Medicare Part D or Medicare Advantage plan (a plan with consistently low quality ratings), you may qualify for an SEP and be able to change plans once, at any time during the plan year.

  • SEP to enroll into a 5-Star Medicare plan.
    You also have the once-a-year opportunity to join a Medicare plan with a “5-Star” quality rating at any time during the year.  (Unfortunately, 5-Star rated Medicare plans are not available in many areas.)  As a reminder, you are allowed to use the 5-Star SEP even if you are already enrolled in a 5-Start Medicare plan and wish to move to another 5-Star plan.

    Important: If you switch to a "5-Star" Medicare Part D prescription drug plan (a plan that only provides drug coverage – PDP) from your current Medicare Advantage plan with prescription drug coverage (health and drug benefits – MAPD), you would be automatically dis-enrolled from your Medicare Advantage plan and would return back to your Original Medicare Part A and B coverage along with your new “5-Star” prescription drug plan.

  • SEP if you receive false or misleading information when enrolling into a Medicare plan.
    Depending on your circumstances, you may be granted a Special Enrollment Period if you were provided false or misleading information when enrolling into your plan. To learn more and see if you qualify for this particular SEP, you will need to contact Medicare at 1-800-633-4227.

  • The Medicare Advantage Open Enrollment Period.
    Although not an SEP, starting in 2019, the Medicare Advantage Open Enrollment Period (MA OEP) is available beginning on January 1st and continued through March 31st of each year.  During the MA OEP you can change your Medicare Advantage plan (MA/MAPD) to another plan or leave your Medicare Advantage plan and return to Original Medicare Part A and Part B - along with the option to enroll in a stand-alone Medicare Part D prescription drug plan.



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