Missed Open Enrollment for Medicare
Discover what options you have to change or add to your coverage.
What Is the Medicare Open Enrollment Period?
The Medicare Open Enrollment Period takes place each year between October 15 and December 7.
During this time, Medicare enrollees can reevaluate their current coverage and make certain changes or additions.
Here are the actions that Medicare enrollees are allowed to make during the Open Enrollment Period:
Switch from Original Medicare to a Medicare Advantage plan, or from a Medicare Advantage plan to Original Medicare.
Switch from one Medicare Advantage plan to a different Medicare Advantage plan, or from one Medicare Part D plan to another Medicare Part D plan.
Enroll in a Medicare Part D plan if you did not enroll when first eligible during your Initial Enrollment Period. Note, however, that a Part D late enrollment penalty may apply.
What If I Missed the Open Enrollment Period for Medicare?
If you were hoping to act during the Open Enrollment Period but missed your chance before the deadline passed, there may still be a few courses of action available to you.
Here are four additional options that you can consider:
1. Act During the Medicare Advantage Open Enrollment Period
One of your options to act after Open Enrollment is during the Medicare Advantage Open Enrollment Period that takes place from January 1 to March 31.
During this period, you have the option of changing from your current Medicare Advantage plan to a different Medicare Advantage plan.
Additionally, you have the option of disenrolling from your current Medicare Advantage plan to revert back to Original Medicare coverage.
If you choose this option, you have the ability to also enroll in a Medicare Part D prescription drug plan.
Note: If you disenroll from your Medicare Advantage plan you will be losing certain benefits that Original Medicare cannot provide, such as the ability to cap out-of-pocket expenses for your Medicare-approved costs.
For this reason, be sure that you will still have adequate care in terms of both coverage and cost if you are going this route.
2. Consider a Medigap Plan
Medigap plans, also known as Medicare Supplement plans, help to fill in the gaps of Original Medicare coverage.
The best time to purchase a Medigap plan is during your Medigap Open Enrollment Period. This period automatically begins once you’re 65 years old and enrolled in Medicare Part B.
The period extends for 6 months and guarantees you the ability to purchase any Medigap plan sold in your state.
Once your Medigap Open Enrollment Period ends, however, the private insurance companies that sell these Medigap plans can deny you coverage based on pre-existing conditions or if you don’t meet their medical underwriting requirements.
However, in some cases you might qualify for a Special Enrollment Period. For example, you may qualify if you recently lost your employer group coverage or Medicare Advantage plan.
3. Check for Special Enrollment Periods
As you consider your options, you may want to check to see if you qualify for a Special Enrollment Period.
In certain circumstances, Medicare allows beneficiaries to change coverage outside of the Open Enrollment Period for qualifying life events.
Some examples of events that qualify are losing your coverage, change in coverage to your plan, or moving to a new location.
You can check to see if your event qualifies here.
Note: You can also look for new 5-Star Medicare plans released during the fall. Medicare plans are rated on a 1 to 5 scale with 5 being considered “excellent”.
As a Medicare beneficiary, you have the option to switch to a 5-Star Medicare Advantage plan, Medicare Prescription Drug plan, or Medicare cost plan once a year between December 8 and November 30.
The plan you switch to must have a five star rating.
4. Change Your Prescription Drugs
If you were hoping to change your prescription drug plan during Open Enrollment because your current plan doesn’t cover your specific prescription, look for ways that you can optimize your current plan.
All Medicare prescription drug plans are required to provide at least two options for each drug category and class.
So, if your current plan doesn’t cover your specific drug, it will cover a different drug that is designed for the same purpose.
Important! Be sure to consult your doctor before making a switch to an alternative drug. It’s possible that your doctor will advise against the alternative due to adverse effects, inefficiency, or other reasons.
In this case, you might want to file an exception request for the preferred medication with your prescription drug plan provider.
Helpful Resources:
Medicare: When Can I Buy Medigap?
Medicare: 5 Star Special Enrollment Period
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