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What happens if I miss Medicare open enrollment?

Open enrollment, your opportunity to choose a Part D prescription drug plan or Medicare Advantage plan for the coming year, is Oct. 15 to Dec. 7. If you miss this annual open enrollment period, you’ll be reenrolled automatically in your current plan as long as it’s offered in your area.

Considering that coverage and costs vary from year to year, your current plan may no longer be your best choice. After open enrollment ends, you may still qualify to switch your coverage in certain circumstances.

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When can I switch Medicare Advantage plans after open enrollment?

If you have a Medicare Advantage plan and want to switch to another plan that provides better coverage for your doctors or drugs — or leave Medicare Advantage for original Medicare — several opportunities exist that may let you make changes after open enrollment, including:

From Jan. 1 to March 31: Anyone with a Medicare Advantage plan can switch to another plan or leave Medicare Advantage for original Medicare and join a Part D plan during this time, called the Medicare Advantage open enrollment period. Your new coverage begins the first day of the month after you switch. You can’t get a Medicare Advantage plan during this time if you don’t already have one.

Be aware: If you leave Medicare Advantage for original Medicare and want a Medigap policy to help cover Medicare’s deductibles and copayments, this supplemental coverage may not be guaranteed. Medigap insurers in most states can charge more or reject you because of preexisting conditions unless you buy a Medigap policy during certain times.

During your first year in Medicare Advantage. You can leave Medicare Advantage for original Medicare anytime during this 12-month trial period. You can also sign up for a Part D prescription drug plan and qualify for a special enrollment period to get Medigap coverage regardless of preexisting conditions.

Other circumstances could make you eligible to switch to a Medicare Advantage plan midyear. If you:

  • Move outside your current plan’s service area. When you relocate, you usually have two months to get a new Medicare Advantage plan or leave Medicare Advantage for original Medicare and get a Part D plan. You can also get a Medigap policy regardless of preexisting conditions.
  • Have a five-star plan in your area. If a locally available Medicare Advantage plan has an overall five-star quality rating from the government, you can switch to that plan one time outside of open enrollment. Coverage begins the first day of the month after the plan receives your enrollment request. You can search for plans with a five-star rating using the Medicare Plan Finder.

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When can I switch Part D plans after open enrollment?

If you discover that another Part D plan has better coverage for your medications, or if your doctor prescribes a new drug that isn’t covered in your plan’s formulary, you may have opportunities to change plans after Dec. 7. If you:

  • Move out of your plan’s service area — you usually have up to two months to change to another plan.
  • Receive financial assistance from the Extra Help program, which helps people with low incomes pay Part D premiums and out-of-pocket costs — you can change Part D plans as often as once per quarter.
  • Find a Part D plan with a five-star quality rating in your area — you can make a one-time switch into that plan outside of open enrollment.
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What happens if I don’t have a Part D or Medicare Advantage plan?

You can sign up outside of open enrollment:

  • During your seven-month initial enrollment period for Medicare, the three months before the month you turn 65 until three months after your birthday month.
  • Within two months of losing medical insurance from your employer or union.
  • Within two months of losing drug coverage considered at least as good as Part D, called “creditable coverage.” This creditable coverage may be from an employer, a retiree plan, Tricare or another source.

Keep in mind

Starting on Jan. 1, 2024, if you sign up for Part A or Part B because of an exceptional condition, such as being unable to sign up in time because of a natural disaster, misinformation from your employer or losing Medicaid coverage, you’ll have two months to join a Medicare Advantage plan or a Part D prescription drug plan. Coverage will start on the first of the month after the plan receives your request to join. 

If you don’t sign up for prescription drug coverage from a Part D or Medicare Advantage plan within these time frames and don’t have other creditable drug coverage, you may have to pay a Part D late enrollment penalty when you eventually enroll.

One last thing to note: Part D and Medicare Advantage deadlines are different from deadlines for enrolling in original Medicare. You still have to sign up for Medicare Part A and Part B during your initial enrollment period at age 65 unless you or your spouse is still working and you have health insurance from a current employer. You have up to eight months after losing employer health insurance to enroll in Medicare without a Part B late enrollment penalty.

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