Medicare Annual Enrollment Period vs. Medicare Advantage Open Enrollment: What’s the Difference?

If you have Medicare, you’ve probably heard about different times of the year when you can change your coverage. Two of the most commonly confused are the Medicare Annual Enrollment Period and the Medicare Advantage Open Enrollment Period.

They sound similar, but they are not the same thing.

Understanding the difference can help you avoid missing an opportunity to make an important change to your Medicare coverage.

Medicare Annual Enrollment Period

The Annual Enrollment Period (AEP) runs each year from October 15 through December 7.

This is the big Medicare enrollment period that most people hear about every fall.

During AEP, Medicare beneficiaries generally have several options. You may be able to:

• Change from one Medicare Advantage plan to another

• Leave Medicare Advantage and return to Original Medicare

• Move from Original Medicare into a Medicare Advantage plan

• Change Medicare Part D prescription drug plans

• Enroll in or drop Part D coverage

Changes made during AEP generally take effect January 1 of the following year.

Medicare Advantage Open Enrollment Period

The Medicare Advantage Open Enrollment Period (MA OEP) runs from January 1 through March 31 each year.

But there is an important catch:

This enrollment period is only for people who are already enrolled in a Medicare Advantage plan.

During this period, you can generally:

• Switch to another Medicare Advantage plan, or

• Leave Medicare Advantage and return to Original Medicare

If you return to Original Medicare, you may also be able to enroll in a standalone Part D prescription drug plan.

You can generally make one change during this enrollment period.

Why Would Someone Want to Change Plans?

Sometimes a Medicare plan looks great on paper, but things change.

Maybe:

• Your doctor is no longer in the network

• A medication is more expensive than expected

• Your preferred pharmacy isn't giving you the best price

• Copays or other costs are higher than you anticipated

• You want different dental, vision or hearing benefits

• You simply realize another type of Medicare coverage may fit you better

That is why reviewing your coverage can be so important.

Be Careful Before Dropping Medicare Advantage

If you're thinking about leaving Medicare Advantage and returning to Original Medicare, there is another piece of the puzzle to consider: Medicare Supplement insurance, also called Medigap.

Leaving Medicare Advantage does not necessarily mean that you are guaranteed to qualify for the Medicare Supplement plan you want.

Depending on your situation and state, you may have to answer health questions and go through medical underwriting unless you have a guaranteed issue or other protected enrollment right.

That means you should understand your Medigap options before making the decision to leave your Medicare Advantage plan.

The Bottom Line

An easy way to remember the difference is:

October 15 – December 7: Most Medicare beneficiaries have an opportunity to review and change their Medicare coverage.

January 1 – March 31: People already enrolled in Medicare Advantage get another opportunity to make certain changes.

Medicare has a lot of enrollment periods, exceptions and special rules. The right time to make a change depends on your individual situation.

If you're unsure what enrollment period applies to you, don't guess. A quick review of your situation can help determine what options are available before you make a change.

Have Medicare questions?

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This article is for general educational purposes and is not intended to provide individualized Medicare, legal, or financial advice.