Medicare open enrollment

The period from October 15 to December 7 when Medicare beneficiaries can make changes to their health insurance

Derek Silva

Derek Silva

Published October 7, 2019

KEY TAKEAWAYS

  • All Medicare recipients can change their Medicare plans during open enrollment

  • Medicare open enrollment for 2020 plans starts on Oct. 15, 2019 and ends on Dec. 7, 2019

  • Changes you make during 2019 open enrollment go into effect on Jan. 1, 2020

Medicare is a federal health insurance program that primarily covers Americans age 65 and older. Younger individuals with certain disabilities or health conditions may also qualify for Medicare coverage.

Medicare open enrollment is the annual period from October 15 to December 7 when people who have Medicare can change their health insurance plan. Specifically, you can apply for or make changes to your Medicare Part C (Medicare Advantage) and Medicare Part D prescription drug plans. All plan changes go into effect on January 1 (not right when you make changes) and last for the year.

Open enrollment for Medicare, also known as the annual election period or AEP, is the only time when everyone who has Medicare is allowed to make changes to their coverage. There are a few other times throughout the year when some Medicare recipients can change their health plans, but not everyone qualifies to make changes during those other times.

In this article:

What is Medicare open enrollment?

Medicare has a few enrollment windows, which are the only times that you can make changes to your Medicare plan. Open enrollment is the only enrollment period where all Medicare beneficiaries can make changes if they want.

Specifically, open enrollment allows you to

  • Switch from Original Medicare (Part A and Part B) to Medicare Advantage (Medicare Part C)
  • Switch from a Medicare Advantage plan to Original Medicare
  • Switch from one Medicare Advantage plan to another
  • Enroll in a Medicare Part D (prescription drug) plan
  • Switch from one Medicare prescription drug plan to another

Who can apply during Medicare open enrollment?

The Medicare open enrollment period is for current Medicare beneficiaries, no matter what types of Medicare you’re enrolled in. It doesn’t matter if you use Original Medicare (Part A and B) or if you have a Medicare Advantage Plan (Part C).

You can’t get a Medicare plan during open enrollment if you aren’t already enrolled in Medicare, unless you also qualify for special enrollment at that time.

For more guidance, we have some tips for seniors heading into Medicare open enrollment.

What if I miss Medicare open enrollment?

If you don’t change your health plan during open enrollment, you will most likely need to keep you current plan for one more year, until the next open enrollment period. There are only a few other times when you may qualify to change your plan.

Special enrollment periods (SEPs)

Special enrollment periods allow Medicare beneficiaries to sign up for or make changes to their Medicare health plans following certain life events. Different events allow you to sign up for different parts of Medicare through a SEP.

You qualify for special enrollment and can sign up for Original Medicare (Part A and Part B) if you leave your job or if you lose health insurance coverage from your employer or your spouse’s employer.

The coverage needs to be considered employer coverage, though. You cannot get a SEP to sign up for parts A and B if you lose health insurance (or prescription drug coverage) because you lost coverage from a COBRA plan, a retiree health plan, VA coverage, or private insurance that you got through the Obamacare marketplace.

However, losing those types of insurance coverage, like COBRA, may still get you a special enrollment to sign up for Medicare Part C and Part D coverage. Just remember that you cannot sign up for either of those parts unless you have already signed up for Original Medicare.

If you need to sign up for Original Medicare but do not qualify for special enrollment, you won’t be able to enroll in Medicare until the next general enrollment period, which is from January 1 to March 31 each year. The only exception is if you are in your initial enrollment period, meaning you just became eligible for Medicare (more on initial enrollment in a bit).

You may also qualify for special enrollment for certain changes to your Medicare plan, like if your insurer made changes to its Medicare contract that result in fewer benefits or coverage options.

Medicare Advantage disenrollment period (MADP)

If you have a Medicare Advantage plan, but you want to get rid of it and switch to Original Medicare, you can do so during the Medicare Advantage disenrollment period (MADP). You can also get a Medicare Part D prescription drug plan during this period.

Medicare Advantage disenrollment runs from January 1 to February 14 every year. Coverage changes go into effect on the first day of the month following your disenrollment. So, if you revert back to Original Medicare on January 2, your new coverage would start February 1.

Medicare Supplement Insurance coverage (Medigap)

Medicare Supplement Insurance, also known as Medigap, helps beneficiaries pay out-of-pocket expenses associated with Original Medicare, including your copays, deductibles, and coinsurance. If you’re struggling with out-of-pocket costs, consider a Medicare supplement plan.

(Low-income individuals should also consider Medicare Savings Programs, MSPs, which lower your out-of-pocket health care costs.)

To apply for a Medigap plan, you must already be enrolled in Original Medicare. Once you enroll in Medicare Part B, you will have a six-month period to enroll in Medigap plans. You can also enroll in a Medigap plan during the standard Medicare open enrollment. It’s possible to cancel and enroll in a new Medigap plan at any time during the year, but insurers aren’t required to accept you for a new plan outside of the Medigap enrollment period.

Learn more about Medigap plans.

Getting Medicare for the first time — initial enrollment period

Individuals who are enrolling in Medicare for the first time do not sign up for Medicare or apply for plans during open enrollment. Instead, they have a seven-month initial enrollment period when they can apply. Initial enrollment starts three months before you turn 65, includes the month of your 65th birthday, and ends three months after your birthday month.

Some Americans are automatically enrolled in Medicare Part A and Medicare Part B (Original Medicare) when they turn 65, so they don’t have to worry about missing their initial enrollment period. You will be automatically enrolled in Original Medicare if you already claim Social Security benefits or Railroad Retirement Board benefits.

If you aren’t automatically enrolled and you don’t sign up during the initial enrollment period, you usually have to wait until the next Medicare general enrollment period to sign up. General enrollment takes place from January 1 to March 31 each year. Coverage then goes into effect on July 1.

Your premiums will be higher if you buy Part A after your initial enrollment period. However, most people receive premium-free Part A. Missing initial enrollment will also result in a penalty that gives you higher Part B premiums.

Learn more about how to apply for Medicare.