The Medicare Open Enrollment Period runs from October 15 to December 7 each year. This is also often called the Annual Enrollment Period, or AEP. During this period, beneficiaries can join, change, or drop an Original Medicare or Medicare Advantage plan.
But if you miss the Medicare Open Enrollment Period, you may eligible for a Special Enrollment Period if you have a qualifying event, or there may be other enrollment options available to ensure you receive the Medicare coverage you need.
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What Is the Medicare Open Enrollment Period?
Medicare’s Open Enrollment Period runs from October 15 to December 7 each year and allows you to switch, drop, or join a Medicare plan. This occurs after Medicare insurers provide documentation of plan changes to beneficiaries, also called an annual notification of changes (ANOC). For example, insurers may choose to raise premium rates or change what is currently covered under existing plans.
Medicare open enrollment offers beneficiaries a chance to review this documentation and decide if they would like to stay with their current plan or change to another.
During this period, you can:
- Change from Original Medicare to Medicare Advantage, or vice versa
- Switch from one Medicare Advantage plan to another
- Join a Medicare drug plan
- Remove your drug coverage
No matter what you choose to do, your new coverage starts on January 1. If you take no action, your Medicare plan is unaffected. Beginning January 1, you would pay the new premium for the plan as stated in your ANOC. If you choose to drop a plan, there is no penalty for canceling and you can sign up for another plan.
Your Next Medicare Enrollment Period Options If You Miss Open Enrollment
There are several Medicare enrollment periods that happen annually. If you miss Medicare open enrollment — also commonly called the Annual Enrollment Period — there are other options, including:
General Enrollment Period
- When: January 1 – March 31
- Coverage Begins: July 1
- What You Can Do: Sign up for Part A and Part B
During the Medicare General Enrollment Period each year, you can enroll in either Part A or Part B coverage if you missed your initial enrollment period or the open enrollment period. Unlike the Open Enrollment Period, coverage changes or modifications are not permitted — instead, people often use the General Enrollment Period to obtain Part A or Part B coverage if they missed their initial enrollment period.
Regardless of when you apply for coverage during this period, coverage itself starts on July 1. This means that if you do not have preexisting health coverage, you could be subject to a penalty for the months you lacked coverage. Signing up for Part A or Part B during the General Enrollment Period also triggers a Part D Special Enrollment Period which runs from April through June, allowing you to enroll in Medicare Part D prescription drug coverage, which also starts in July.
Medicare Advantage Open Enrollment Period
- When: January 1 – March 31
- Coverage Begins: The first of the month after the month you ask to join the plan
- What You Can Do: Switch your Medicare Advantage Plan or drop it and enroll in Original Medicare
Like the General Enrollment Period, the Medicare Advantage Open Enrollment Period (MAOEP) runs from January 1 to March 31 each year. However, the actions permitted differ. During this time, you can switch from one Medicare Advantage Plan to another — with or without drug coverage — or you can drop your current Medicare Advantage plan and return to Original Medicare. If you choose this option, you are also able to enroll in a separate Medicare drug plan.
However, you cannot switch from Original Medicare to an Advantage plan, join a Part D plan, or switch from one Part D plan to another. For example, if you have a Medicare Advantage plan but want to move to a different Advantage plan that does not have a drug plan, you can do this during the MAOEP. But if you want to move from Original Medicare to Medicare Advantage, you will need to wait for the next AEP.
Do You Qualify for a Special Enrollment Period?
- When: Depends on the circumstance
- Coverage Begins: Depends on the circumstance
- What You Can Do: Depends on the circumstance
Special enrollment periods (SEPs) differ from those listed above because they are not tied to specific calendar dates. Instead, they are prompted by life events or circumstances that in turn allow you to make changes to your Medicare coverage and avoid the penalties that come with a missed Medicare enrollment period.
Eligible Circumstances for a Special Enrollment Period
Some of the special circumstances that trigger SEPs include:
- You move to a new address that isn’t covered under your current plan’s service area
- You’re no longer eligible for Medicaid
- You left coverage from an employer or union
- Medicare terminates your plan’s contract
- You joined (or did not join) a plan due to an error
For example, if you moved to a new address that is not covered by your current plan, you can switch to a new Medicare Advantage plan or Medicare Part D any time in the month before you move or in the two months after you move. Likewise, if you lost health coverage from an employer or union (including COBRA), you have two months after your coverage ends to join a Medicare Advantage plan or a Medicare Part D plan.
Switching to a 5-Star Plan
- When: December 8 and the following November 30
- Coverage Begins: January 1
- What You Can Do: Change from a lower-star Medicare Advantage or Part D plan to a 5-star plan
Another special enrollment period type is if you want to switch 5-star Medicare Advantage or Part D plans. Every year, Medicare collects data from plan providers, health care agencies, and beneficiaries to assign performance star ratings to Medicare Advantage and Part D plans. The higher the number of stars, the better: a 1-star plan indicates a low level of satisfaction and service, while a 5-star plan indicates high quality and performance.
The 5-star special enrollment period offers you an opportunity to move from a lower-star plan to a 5-star option. During this SEP, you can switch your current lower-star plan for a Medicare Advantage Plan, Medicare drug plan, or Medicare Cost Plan with a 5-star rating. You may only use this SEP once each year.
Possible Penalties for Late Medicare Enrollment
If you miss the Medicare enrollment deadline during your Initial Enrollment Period or open enrollment, you may face late enrollment penalties. The penalties differ based on the type of Medicare coverage and the length of time you have been without coverage.
Part A Late Enrollment Penalty
If you are not eligible for premium-free Part A, you need to purchase Part A Medicare during your Initial Enrollment Period, which runs three months before and after your birthday month the year you turn 65. If you miss your Medicare Part A enrollment period, you may be subject to the Part A late enrollment penalty, where your monthly premium increases 10% for twice the number of years you did not sign up.
For example, if you were eligible for Part A three years ago but did not enroll until now, you would pay a 10% percent increase on your monthly premium for twice the number of full years you were eligible and did not sign up. In this case, that would be 6 years of paying the 10% premium penalty.
Part B Late Enrollment Penalty
If you do not sign up for Part B Medicare coverage when you are first eligible, you could see a permanent premium increase. For each 12-month period you could have had Part B but did not enroll, your premium increases by 10%, and this increase may be permanent.
For example, if you waited two years to enroll in Part B after you were eligible, your monthly premium could go up by 20% for as long as you have Part B coverage.
Part D Late Enrollment Penalty
The Part D late enrollment penalty applies if you go 63 consecutive days or more without Medicare or credible drug coverage. For each month that you did not have coverage, you are assessed a premium penalty of 1% of the national base beneficiary premium, which was $33.37 in 2022, rounded to the nearest $0.10.
For example, if you were without credible drug coverage for 10 months before enrolling in Part D, your penalty would be 10% of $33.37, which is $3.37. This is then rounded to $3.40, meaning you might pay an extra $3.40 on your Part D insurance for as long as you have Medicare drug coverage.
How to Avoid Late Penalties
Special Enrollment Periods could help you avoid late penalties. For example, if you had coverage through your job and this coverage is no longer available, you have two months after your coverage ends or after you are notified that the coverage is ending to enroll in a Medicare Advantage plan with no late penalty.
Check to see if you are eligible for any Special Enrollment Periods to avoid paying late enrollment penalties and also avoid having to wait for the next enrollment period to make any necessary changes.
What You’ll Need to Enroll in Medicare
To enroll in Medicare, you will need documents including your birth certificate, proof of U.S. citizenship or residency, your Social Security card, and information about any other health insurance coverage you have.
If you want to enroll in Original Medicare, you can apply online, work with a trusted insurance agent, apply over the phone, or visit your local Social Security office in person. If you are looking for a Medicare Advantage plan, you can search for available plans on your own or work with an insurance agent to see what types of Advantage plans are in your area.