You Missed Medicare Open Enrollment: Now What?
If you realized that the December 7 Medicare Open Enrollment deadline passed, you are not alone.
That is a busy time of year, and Medicare’s complex rules often slip through the cracks of holiday planning. While missing that window means you cannot make certain changes to your coverage for a while, the new year brings several second chances that many people overlook.
If you find yourself in the early months of the year with the wrong coverage (or none at all), here are your options between January and March.
The Medicare Advantage open enrollment period
If you already enrolled in a Medicare Advantage plan (Part C), you can make changes between January 1 and March 31. This is known as the Medicare Advantage Open Enrollment Period.
During these three months, the federal government allows you to make exactly one change to your coverage. You can switch to another Medicare Advantage plan or return to Original Medicare (Parts A and B). If you choose to go back to Original Medicare, you can also sign up for a Part D prescription drug plan at that time.
This window is particularly helpful if you discovered in January that your favorite doctor left your plan’s network or that your co-pays for specific medications became too expensive. This period provides a fallback option for those who feel they made a mistake during fall-to-winter enrollment.
The general enrollment period
You may have missed more than one enrollment opportunity; maybe you missed your initial Medicare enrollment period when you turned sixty-five. If you are not yet enrolled in Part A or Part B and do not qualify for certain special exceptions (see more below), you can use the general enrollment period.
This period also runs from January 1 through March 31. When you sign up for Medicare between these dates, your coverage typically begins the first day of the month after you submit your application. Keep in mind that if you wait too long to sign up, you might face a late-enrollment penalty that increases your monthly premiums for as long as you have coverage. However, signing up now prevents those penalties from growing even larger in the future.
Qualifying for a special enrollment period
Life does not always follow the government’s calendar. If you experience a major life change, you may qualify for a Special Enrollment Period (SEP), which allows you to change your coverage. Common triggers for an SEP include:
- Moving to a new address outside your current plan’s service area.
- Losing your current coverage, such as through an employer or a union.
- Gaining eligibility for “extra help” with prescription drug costs or Medicaid.
- Moving into or out of a skilled nursing facility or long-term care facility.
Most SEPs last for sixty days following the qualifying event. If you recently moved or retired, check your eligibility as soon as possible to ensure that you don’t miss this narrow window.
Missing the December deadline might feel like a setback, but the first quarter of the year offers you several ways to get back on course. Take a moment this week to review your current plan’s costs and doctor networks. If they don’t meet your needs, you may want to act before the March 31 deadline. If you need more information about these or other Medicare concerns, speak with an insurance professional.