What to do if you miss Medicare’s Open Enrollment

October 4, 2021

Medicare’s enrollment periods can quickly get confusing. Depending on your policy, there are only certain times of year that you can cancel, switch, or enroll in a new plan. Let’s break it all down:

  • Initial Enrollment – 3 months before your 65th birthday – 3 months after your 65th birthday
    • For those newly eligible for Medicare
    • Sign up for Medicare (Part A and Part B)
    • Choose a Medicare Advantage Plan
    • Enroll in a Prescription Drug (Part D) Plan
  • Medicare Advantage and Prescription Drug Plan Annual Enrollment Period – Oct. 15 – Dec. 7
    • For all Medicare beneficiaries
    • Switch from Medicare to a Medicare Advantage Plan or vice versa
    • Change your Medicare Advantage Plan
    • Change your Prescription Drug (Part D) Plan
    • Enroll in a Prescription Drug (Part D) Plan

See if you qualify for a Special Enrollment Period

If you have a major life event, you may qualify for a Special Enrollment Period. Things like moving out-of-state, retirement, change in marital status, or loss of insurance can qualify for this enrollment period.  You will be able to change plans and enroll in new coverage following a qualifying life event.

See if you qualify for a Special Needs Plan

If you’re wanting to change health care plans to get a plan that better meets your medical needs, you may want to look into a Special Needs Plan.

Special Needs Plans are Medicare Advantage plans that cater to people with certain health conditions. These include:

  • Chronic alcohol or drug dependence
  • An autoimmune disorder, such as lupus
  • Chronic heart failure
  • Diabetes mellitus
  • End-stage renal disease needing dialysis
  • HIV or AIDS

Call 1-800-MEDICARE (1-877-486-2048) TTY: 1-877-486-2048 or your local State Health Insurance Assistance Program to learn whether you could qualify for a Special Needs Plan.

Speak with your doctor about prescription alternatives

Many people change plans during the Open Enrollment Period because their current plan doesn’t cover the drugs they take. If you can’t change your plan, consider changing your prescriptions.

You should never make this decision without medical advice. Because the Medicare Modernization Act requires every plan with prescription drug coverage to cover at least two drugs in any drug class and category, you can likely find something similar to treat your condition at a lower out-of-pocket cost. Speak to your doctor about drug alternatives and make the switch under his or her care.

SmartMatch can help

Free, no obligation Medicare consultations, resources, and enrollment services are just a phone call away. SmartMatch makes it easy to find a plan that best fits your unique health care needs and budget. Visit our Plan Comparison tool or call us at (888) 411-7647 TTY: 711 to get started.

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