What are my options if I missed AEP

What are my options if I missed AEP? 

Although we do our best to adhere to deadlines, life happens. Maybe you missed the deadline to enroll in Medicare or change your plan because there were competing priorities, causing something else to take precedence. In some cases, due to a misunderstanding, some people may assume Medicare enrollment is automatic. 

Automatic enrollment applies if you:

• Receive Social Security (SS) or Railroad Retirement Board (RRB) benefits when you turn 65
• Are under 65 years of age and received disability payments from SS or “certain disability benefits from the RRB” for two years
• Have Lou Gehrig’s disease, synonymous with amyotrophic lateral sclerosis (ALS), and your SS disability benefits have begun

Otherwise, the Initial Enrollment Period applies. This is the seven-month enrollment period encircling your 65th birthday month. 

Medicare’s Annual Enrollment Period goes from October 15 through December 7 each year and gives Medicare recipients the opportunity to make changes to their coverage. If you missed your chance during AEP, you may have other options, including Special Enrollment Periods.

Special Enrollment Periods

Special Enrollment Periods apply for a number of reasons. You may experience a life event, such as moving. Perhaps you are still working or you are covered under your spouse’s plan. If you have a disability, you may have coverage under a family member’s group health insurance plan. For instance, if the reason you did not enroll during the Initial Enrollment Period is that you already have health insurance, you may be eligible for a SEP when that employment or coverage ends.
Those eligible for Special Enrollment Periods can enroll in Medicare Part A and Part B during these times: 

• While still a member of the group health plan coverage
• During an eight-month period, which begins either the month after the employment or the coverage terminates, whichever comes first

Typically, you would not be charged a late enrollment penalty if you sign up during the Special Enrollment Period. However, there are these exceptions:

• Your eligibility for Medicare is predicated on End-Stage Renal Disease (ESRD), in which case you should check with your Social Security office when and how to enroll.
• Your Initial Enrollment Period has not yet ended.

You are not qualified for a Special Enrollment Period if:

• You have a disability AND
• Your group health plan coverage is tied to a family member’s active employment AND
• That family member is not a spouse AND
• The family member’s employer has less than 100 employees.

General Enrollment Period

If you missed your Initial Employment Period and do not meet the qualifications for the Special Enrollment Period, you may join during the General Enrollment Period. This occurs every year from January 1 through March 31. Late enrollment fees may apply and your coverage will not begin until July 1.

AEP

The Annual Election, or Enrollment, Period (AEP), runs from October 15 to December 7. This is the time when current Medicare participants can change from one plan to another. You can also enroll in Part D for prescription drugs. If the plan receives your request by the end of this period, your new coverage will start January 1.

If you miss AEP, you will have an opportunity to make a change during the Medicare Advantage Open Enrollment Period MA-OEP but only if you are already a Medicare Advantage (MA) plan member.

Medicare Advantage Open Enrollment Period MA-OEP

During the Medicare Advantage Open Enrollment Period MA-OEP, which takes place from January 1 through March 31 every year, you can replace your plan with another MA plan. You can also leave your MA plan and revert to Original Medicare. You have the option to sign up for a Medicare prescription drug plan, which is important if you dropped an MA plan that included drug coverage.  

Only one change is allowed during this period. Your new selection will take effect the first of the month following the plan’s receipt of your request.