What If You Missed the Annual Enrollment Period?

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The Medicare Annual Enrollment Period (AEP) comes around every year between October 15 and December 7, giving you the chance to review and adjust your Medicare coverage. But what happens if the AEP passes and you didn’t make any changes? First, don’t panic—you may still have options!

The good news is that depending on your situation, there are other opportunities to make changes to your Medicare coverage. In this blog, I’ll break down what you can do if you missed the Annual Enrollment Period and how I can help you navigate the next steps.

Option 1: Medicare Advantage Open Enrollment Period (OEP)

If you’re enrolled in a Medicare Advantage Plan (also known as Part C), you have another window of opportunity to make changes. The Medicare Advantage Open Enrollment Period runs from January 1 to March 31 every year.

Here’s what you can do during this time:

  1. Switch to a different Medicare Advantage Plan. If you’re not happy with your current plan—maybe your doctor isn’t in-network anymore, or your copays went up—you can switch to another Medicare Advantage Plan that better suits your needs.w
  2. Return to Original Medicare (Parts A and B). If you decide that Medicare Advantage isn’t the right fit, you can go back to Original Medicare.
  3. Enroll in a standalone Part D Prescription Drug Plan. If you return to Original Medicare, you can sign up for a Part D plan to ensure you still have coverage for your prescriptions.

The key to this period is that you can only make one change, so it’s important to choose wisely. If you’re considering switching plans or returning to Original Medicare, I’m here to help you weigh your options and make the best decision.

Option 2: Special Enrollment Period (SEP)

If you experience certain qualifying life events, you may be eligible for a Special Enrollment Period (SEP) to make changes to your coverage outside of the typical enrollment windows.Here are some common situations that may qualify you for an SEP:

  1. You moved to a new service area.
    • If you moved to a different city, state, or even just outside of your current plan’s service area, you can switch to a new Medicare plan that works in your location.
  2. You lost other health coverage.
    • If you had employer-sponsored coverage, COBRA, or another type of plan that ended, you may qualify for a Special Enrollment Period to sign up for Medicare or make changes to your existing plan.
  3. You’re newly eligible for Medicaid.
    • If you qualify for Medicaid or have changes in your eligibility, you may be able to adjust your Medicare plan to better align with your new coverage.
  4. Your plan no longer meets your needs.
    • If your current plan was terminated or you experienced other plan-related changes beyond your control, you could qualify for an SEP.
  5. Other exceptional circumstances.
    • Life happens, and there are sometimes unique circumstances that may qualify you for an SEP. If you think something applies to you, let me know, and I’ll help you figure it out.

Why Timing Matters

If you’re eligible for the Medicare Advantage OEP or a Special Enrollment Period, it’s important to take action as soon as possible. Missing these windows could mean waiting until the next Annual Enrollment Period (October 15–December 7) to make changes to your coverage.

What If You Didn’t Make Any Changes—Should You Be Concerned?

If you didn’t make changes during the Annual Enrollment Period, don’t worry. If your current plan still meets your needs, you’re in good shape! Your Medicare Advantage or Prescription Drug Plan will automatically renew for the next year, so you’ll continue to have coverage.

However, I always recommend reviewing your plan at the beginning of the year to make sure:

  • Your doctors and specialists are still in-network.
  • Your prescriptions are covered, and you’re not overpaying for medications.
  • There haven’t been unexpected changes to your plan’s costs, like premiums, copays, or deductibles.

Even if you didn’t make changes during AEP, let’s take a moment to ensure your plan still works for you. I can help you confirm your coverage and address any concerns so there are no surprises in 2025.

Don’t Wait—Let’s Talk Today

If you missed the Annual Enrollment Period, you still have options—but time is limited. Whether you’re considering switching Medicare Advantage Plans, going back to Original Medicare, or exploring whether you qualify for a Special Enrollment Period, I’m here to help.

Warm regards,

Michele Sanchez
Michele Sanchez Insurance Agency
(239) 682-8567