What Happens if You Need to Make Changes to Your Medicare Plan After AEP?

Right now, participating in Medicare’s Annual Election Period will allow you to make changes to your current plan. Medicare AEP ends on December 7, and any changes that you make will take effect on January 1.

But what if you miss the Medicare AEP window in the fall? Are you stuck with your plan for another year, or can you make changes outside of AEP?

If you’re enrolled in a Medicare Advantage Plan, an open enrollment period from January 1 through March 31 allows you to make changes. During this time, you can:

  • Switch from one Medicare Advantage plan to another
  • Drop your Advantage plan and return to Original Medicare

However, those who are enrolled in Original Medicare cannot change into a Medicare Advantage plan at this time.

As for Medigap plans, you can apply at any time. However, if you’re out of your original six-month Medicare enrollment period, you will have to pass a health screening and are not guaranteed coverage.

Depending upon your circumstances, you can also qualify for a Special Enrollment Period (SEP) at any time during the year. During a two-month SEP, you add, drop, or change a Medicare Advantage plan. You can also add or drop a Part D (prescription drug) plan to Original Medicare. If any of the following circumstances occur outside of AEP, you can qualify for a SEP:

  • You move to a new service area
  • You move within your current service area, but the move allows for new options to be available to you
  • Your current Advantage plan stops servicing your area
  • You lose creditable drug coverage on your medications
  • You are leaving individual, union, or COBRA healthcare coverage
  • You move into, or out of, a nursing facility

The above are just some of the more common qualifying events for a SEP. If you experience a change in your life that you believe might qualify you, check on the Medicare website to see if you qualify for a SEP, or call us and we will help you investigate your options.

Posted by PGIA
3 years ago / October 26, 2021

Filed Under: Medicare Info