2023 Guide to Medicare AEP

Medicare is a federal health insurance program for people 65 and older and younger adults with certain disabilities. The program can help enrollees pay for a variety of medically necessary and preventive health services, including surgeries, hospital stays, doctor visits, and lab tests. Like other types of health insurance, you can only make changes to your coverage at specific times during the year. The Annual Enrollment Period, sometimes known as Fall Open Enrollment, is one of those times.

What Is the Medicare Annual Enrollment Period?

The Medicare Annual Enrollment Period (AEP) is a yearly window when those who are already enrolled in Medicare can change their existing coverage. Note that those without current Medicare coverage cannot use this period to enroll for the first time.

Medicare Parts A and B, also known as Original Medicare, is the traditional program managed by the federal government, and it offers coverage for medically necessary services like doctor visits and hospital stays. Medicare Advantage plans, on the other hand, are an alternative offered by private companies. These plans also cover Part A and B services, but may have additional coverages as well as different out-of-pocket costs and rules for accessing care. 

During the Annual Enrollment Period, those already enrolled in a Medicare Advantage plan or Original Medicare are eligible to make changes to their plans, such as switching from Original Medicare to a Medicare Advantage plan, or vice versa.

There are other enrollment periods for Medicare, but there are limitations as to what changes can be made during each period. For example, during the Initial Enrollment Period, newly eligible people can enroll in Medicare, and during the Medicare Advantage Open Enrollment Period, people who are specifically enrolled in a Medicare Advantage plan can make coverage changes. 

When Is the Medicare Annual Enrollment Period?

The Medicare Annual Enrollment Period runs from October 15 to December 7 each year. When someone makes a change to their Medicare coverage during the AEP, their new coverage begins on January 1. This means your new Medicare benefits will begin on the first day of the new year.

Who Can Use the Medicare Annual Enrollment Period?

The Medicare AEP is a time when people who are already enrolled in Medicare can make changes to their existing coverage. Whether you have Original Medicare or Medicare Advantage, you could choose to join, switch, or drop a plan during this period.

If you don’t have Medicare yet but are eligible for the program, you could sign up at the following times, which may or may not overlap with the Medicare AEP:

• Initial Enrollment Period: This 7-month window starts 3 months before you turn 65 and ends 3 months after your birthday month.
• General Enrollment Period: People who didn’t sign up during initial enrollment can get Parts A and B between January 1 and March 31.
• Special Enrollment Period: Certain personal circumstances, such as leaving a job that provides health insurance, may trigger a SEP at any time of the year.

What Can You Do During the Medicare Annual Enrollment Period?

During the Medicare Annual Enrollment Period, people with Medicare can make a variety of changes to their coverage. Overall, these are the changes beneficiaries can make during this period:

• Switch from Original Medicare to a Medicare Advantage plan
• Leave a Medicare Advantage plan and return to Original Medicare
• Switch to a different Medicare Advantage plan
• Join or leave a Medicare prescription drug plan, also known as Part D
• Switch to a different Medicare Part D plan

There may be some limitations depending on your current enrollment situation. To better understand what you can do during the AEP window, consider your current enrollment status.

Currently Enrolled in Original Medicare

• You have Original Medicare only, or Part A and/or Part B only: You may join a Medicare Advantage plan with or without bundled Part D coverage, join a Part D plan, or join both if your Advantage plan does not offer bundled Part D coverage
• You have Original Medicare and Part D: You may join a Medicare Advantage plan with or without bundled Part D coverage, switch to a different Part D plan, or drop Part D coverage entirely

Currently Enrolled in Medicare Advantage

• You have Medicare Advantage with bundled Part D coverage: You may switch a different Medicare Advantage plan with or without bundled Part D coverage, switch back to Original Medicare, or join a stand-alone Part D plan if you also switch to an Advantage plan without bundled Part D or switch back to Original Medicare
• You have Medicare Advantage without bundled Part D coverage: You may switch a different Medicare Advantage plan without bundled Part D coverage, switch to a different Medicare Advantage plan with bundled Part D coverage, or switch back to Original Medicare

Keep in mind that there may be future penalties for some changes made during the AEP, such as leaving a Medicare prescription drug plan. If you leave a Medicare drug plan and do not have comparable coverage from another plan, you may pay the Part D late enrollment penalty if you decide to join another Medicare drug plan in the future.

AEP Does Not Extend to Medigap

The Medicare AEP does not apply to Medigap plans. Instead, there’s a separate open enrollment period for Medigap. The 6-month Medigap Open Enrollment Period begins the month you turn 65 and are enrolled in Part B. Outside of this open enrollment period, you could still apply for Medigap, but insurance companies may decline coverage or charge higher premiums. Some states also offer their own recurring annual enrollment periods for Medigap plans.

Why Change Your Medicare Plan During the Annual Enrollment Period?

During the Annual Enrollment Period, people with Medicare may decide to make a variety of changes, such as switching from Original Medicare to Medicare Advantage or joining a different Medicare Part D plan. Some reasons you may consider changing your Medicare plan include:

• Cost: Premiums, deductibles, copayments, and annual out-of-pocket maximums may vary from one plan to another. Medicare members who want to unlock money in their monthly budgets may consider switching to a different plan with lower out-of-pocket costs. 
• Provider network: Doctors and other healthcare providers may choose to leave a Medicare Advantage plan’s network. If your doctor no longer accepts your plan, you could switch to a plan they participate in or return to Original Medicare.
• Covered services: Medicare Advantage plans may cover services that Original Medicare does not, such as vision, hearing, and dental care. Original Medicare members who want these supplemental benefits may switch to a Medicare Advantage plan during the AEP. 
• Drug formulary: Medicare drug plans and Medicare Advantage plans with drug coverage may periodically change the list of drugs they cover. If your plan no longer covers your drugs, you may choose to switch to a plan that does during the AEP.
• Plan rules: Medicare Advantage plans may set rules about how members access care, such as requiring referrals for specialist visits or pre-authorization for certain services. If you don’t like your plan’s rules, you could switch to a different plan or go back to Original Medicare.

Making changes during the AEP is optional. Medicare members who are satisfied with their current coverage can continue their enrollment without changes so long as their plan is still being offered. 

Annual Enrollment Period (AEP) vs. Open Enrollment Period (OEP)

There are two recurring enrollment periods for people with Medicare: the Annual Enrollment Period, which runs from October 15 to December 7, and the Medicare Advantage Open Enrollment Period, which runs from January 1 to March 31.

Unlike the AEP, which is for anyone with Medicare, the Medicare Advantage Open Enrollment Period is only for people who are enrolled in a Medicare Advantage plan. Options during this enrollment period are limited to switching to a different Medicare Advantage plan or leaving Medicare Advantage and returning to Original Medicare. People who go back to Original Medicare could also buy a Medicare drug plan during this time.

During the Medicare Advantage Open Enrollment Period, people with Original Medicare are not permitted to make changes, such as switching to a Medicare Advantage plan or joining a Medicare drug plan. These changes can be made during the AEP instead.

What You’ll Need to Change Medicare Plans

If you’re already enrolled in Medicare and want to make changes during the AEP, be prepared to provide your Medicare number and the dates your Part A and/or Part B coverage began. You can find this information on your Medicare card. If you’ve misplaced your Medicare card, you can request a replacement by using your Social Security online account or calling 1-800-772-1213 (TTY 1-800-325-0778).

During the AEP, Medicare members may choose to switch between Original Medicare and Medicare Advantage or to enroll in a different Medicare Advantage plan or Medicare drug plan. These changes can be made by contacting Medicare or the plan provider.

Additional Resources

The Centers for Medicare & Medicaid Services: This is the official website of the Centers for Medicare & Medicaid Services (CMS), which administers the Medicare program. It provides information on the annual enrollment period, including key dates, coverage options, and how to make changes to your coverage. You can find this information at: Joining a Health or Drug plan

The Social Security Administration: This is the official website of the Social Security Administration, which provides information on the annual enrollment period for Medicare. It explains when the enrollment period takes place, what changes can be made, and how to enroll. You can find this information at: When to Sign Up For Medicare

Medicare Interactive: This is a non-profit organization that provides information and assistance to people with Medicare. Its website provides information on the annual enrollment period, including what changes can be made, how to compare plans, and where to get help. You can find this information at: Six things to know about Fall Open Enrollment

The National Council on Aging: This is a non-profit organization that provides information and resources on a range of issues affecting older adults, including Medicare. Its website provides information on the annual enrollment period, including what changes can be made, how to compare plans, and where to get help. You can find this information at: Medicare Enrollment Periods