What Happens if You Missed the Annual Election Period?

The Medicare Annual Election Period (AEP), which ran from October 15 to December 7, is the key time for beneficiaries to review, compare, and make changes to their Medicare coverage. But what happens if you didn’t take action during AEP? Missing this window can have consequences, but there are options. Understanding your choices can help you avoid gaps in coverage or unexpected costs.

Why Missing AEP Matters

During AEP, Medicare beneficiaries can:

• Switch from Original Medicare to a Medicare Advantage plan

• Switch from Medicare Advantage back to Original Medicare

• Change from one Medicare Advantage plan to another

• Enroll in or switch Part D prescription drug plans

If you missed this window, you generally must wait until the next Annual Election Period to make voluntary changes, unless you qualify for a Special Enrollment Period (SEP). That means your current plan will remain in effect, and you may continue to pay premiums for coverage you no longer need or that no longer fits your health needs.

Potential Consequences of Missing AEP

Staying in a Plan That Doesn’t Fit Your Needs: Plans change each year. Your premiums, deductibles, copays, or covered medications may have increased. If you didn’t review your plan during AEP, you might be paying more than necessary or facing coverage gaps.

Limited Flexibility: Without qualifying for an SEP, you cannot switch plans until the next AEP. This could be almost a full year before you can make voluntary changes.

Higher Out-of-Pocket Costs: If your medication coverage changed or your preferred doctors left the plan network, missing AEP could mean unexpected medical bills or out-of-network charges.

Risk of Late Enrollment Penalties: If you didn’t enroll in Part D prescription drug coverage when first eligible and didn’t maintain creditable coverage, missing AEP could trigger a late enrollment penalty.

Options After Missing AEP

While AEP is the primary period for making changes, there are several Special Enrollment Periods (SEPs) that may allow you to adjust your coverage:

• Moving or relocating to a new area where your current plan isn’t available

• Losing other credible coverage, such as employer or union health insurance

• Qualifying life events, like turning 65 without enrolling or gaining Medicaid

• Enrollment errors, where you didn’t get the coverage you intended

Each SEP has specific rules and time frames, so it’s important to act quickly if you believe you qualify.

Steps to Take if You Missed AEP

1. Review your current coverage. Check your plan for any cost or coverage changes that took effect January 1. Make sure you understand how your medications, providers, and benefits are affected.

2. Assess your needs. Consider your health needs for the upcoming year. If your plan still meets your requirements, you may decide to stay enrolled. If it doesn’t, look into potential SEPs.

3. Contact a licensed Medicare broker. A Medicare broker can help you determine if you qualify for an SEP and guide you through available options. They can also provide strategies to manage costs and ensure access to your preferred providers and medications.

4. Mark your calendar for the next AEP. If no SEP applies, plan ahead for next year. Keep track of deadlines, review your plan’s Annual Notice of Change (ANOC) in the fall, and be ready to make changes during the next AEP.

Get Medicare Help Today

Missing the Annual Election Period doesn’t mean you’re permanently stuck with your current plan, but it does limit voluntary changes until the next AEP unless you qualify for a Special Enrollment Period.

By reviewing your plan, understanding your health needs, and consulting with a licensed Medicare broker, you can minimize the impact and ensure your coverage aligns with your needs. Planning ahead now can make next year’s AEP much smoother and prevent gaps or unexpected costs.