Understanding Medicare enrollment periods is essential to maintaining coverage that fits your healthcare needs and budget. Medicare has specific windows during the year when beneficiaries can enroll in, change, or review their coverage. Missing these timeframes may limit your options or coverage. Below is an overview of the three key enrollment periods: the Annual Enrollment Period (AEP), the Open Enrollment Period (OEP), and Special Enrollment Periods (SEPs).

Medicare Annual Enrollment Period (AEP)

The Annual Enrollment Period occurs each year from October 15 through December 7. This is the most comprehensive enrollment period and applies to all Medicare beneficiaries.

During AEP, individuals can enroll in a Medicare Advantage plan, Switch between Medicare Advantage plans, Return to Original Medicare from Medicare Advantage or Enroll in, change, or drop a Medicare Part D prescription drug plan

Any changes made during AEP take effect on January 1 of the following year. This is an important time to review coverage, provider networks, prescription drug formularies, and costs for the upcoming year.

Medicare Open Enrollment Period (OEP)

Medicare Open Enrollment Period takes place annually from January 1 through March 31. This enrollment period applies only to individuals currently enrolled in a Medicare Advantage (Part C) plan.

During OEP, beneficiaries may switch from one Advantage plan to another,
Disenroll from a Medicare Advantage plan and return to Original Medicare and add a stand-alone Medicare Part D prescription drug plan if returning to Original Medicare

Only one change may be made during this period. Coverage changes become effective the first day of the month following the request. OEP does not allow individuals to enroll in Medicare Advantage for the first time if they are currently in Original Medicare.

OEP is best thought of as a “course correction” window for Medicare Advantage members who realize their plan isn’t meeting their needs after the new year begins.

 

Special Enrollment Periods (SEPs)

Special Enrollment Periods allow eligible individuals to enroll in or make changes to Medicare coverage outside of OEP and AEP due to qualifying life events or circumstances.

Examples of events that may trigger an SEP include Moving outside a plan’s service area,
Leaving employer or group health coverage, Gaining eligibility for Medicaid or Extra Help, or movement into long term care facility.

The length and timing of an SEP depend on the event. Not all beneficiaries qualify for an SEP, and available plan options may vary.

Getting Help with Medicare Decisions

Enrollment rules can be complex, and individual circumstances can change over time. Medicare Insurance Specialists of the Shoals works alongside beneficiaries to help them understand their Medicare options and support them with the plans they choose. Taking time to review coverage each year and knowing when changes are available can help ensure Medicare coverage continues to reflect evolving healthcare needs.

This information is for educational purposes only and does not constitute plan enrollment or a recommendation of any specific Medicare plan or coverage.