Changes You Can Make During Medicare Annual Enrollment

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Dear Toni,

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I turned 65 in February and did not enroll in a Medicare Prescription Drug plan. I’ve been told I must wait until October for Medicare’s Annual Enrollment time. I need help now because I have been diagnosed with Parkinson’s, and my brand-name prescription is very expensive. I thought I could enroll at any time of the year. What can I do?

James from Memorial, TX

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older lady on laptop smiling medicare annual enrollment

Hello James,

Medicare’s Annual Enrollment involves only enrolling in a standalone Part D Medicare Prescription Drug plan or a Part C Medicare Advantage plan with or without Medicare Prescription Drug plans.

Important: Medicare Annual Enrollment does not involve changing or enrolling in a Medicare Supplement.

Medicare’s Annual Enrollment Period is only for enrolling in or changing a Medicare Part C Medicare Advantage Plan and Part D Medicare Prescription Drug Plan.

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Medicare Annual Enrollment starts on October 15th, and it will end at midnight on December 7^th (Pearl Harbor Day). All plans will have January 1^st as their start date.

2025 medicare annual enrollment period infographic by senior resource

This is the time when you can make changes to your Medicare Part D Prescription Drug plan or Medicare Part C Advantage plan. Or, you could enroll if you missed your enrollment time when you were first eligible, like you did, James, when you turned 65.

Changes You Can Make During Medicare Annual Enrollment

Enroll in a Medicare Part D Prescription Drug Plan.
Change from one Part D Medicare Prescription Drug Plan to a new Part D Medicare Prescription Drug Plan.
Enroll in a Part C Medicare Advantage Plan with Prescription Drugs
Change from one Part C Medicare Advantage Plan with or without Prescription Drug plans to a new Part C Medicare Advantage Plan.
Return to Original Medicare and purchase a Medicare Supplement and enroll in a standalone Part D Medicare Prescription Drug Plan.
Return to Original Medicare only and enroll in a Part D Medicare Prescription Drug Plan
Or return to Original Medicare with no Part D plan.

Important: Don’t forget there is a penalty for not enrolling in a Part D Medicare Prescription Drug plan when first eligible.

For those who already have either a Part C Medicare Advantage plan with or without prescription drugs or a standalone Part D Medicare Prescription Drug plan, Medicare’s Annual Enrollment is the time to make sure your drug plan or Medicare Advantage plan still meets your needs, especially if you had any changes to your health.

Can you change your coverage at other times throughout the year?

If you miss the AEP, you might be thinking you missed the Medicare boat completely. Fortunately, that’s not true! You might be eligible to make changes during other enrollment periods, provided that you meet certain criteria.

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General enrollment period

Starting on January 1st and ending on March 31st, you can make some changes during this time, including:

Enroll in Medicare Parts A and B if you didn’t enroll when you were first eligible.
Join a Medicare Advantage Plan if you already have Part A coverage and get Part B coverage for the first time during this enrollment period.

Note: Your coverage will begin July 1st. You may have to pay a late enrollment penalty.

Medicare Advantage OEP

Like the general enrollment period, this runs from January 1st through March 31st. During this time, you can:

Switch to a different Medicare Advantage plan, with or without prescription drug coverage.
Switch from a Medicare Advantage plan to Original Medicare.
Enroll in a Part D plan if you’re switching to Original Medicare

Please note: You can only make ONE change during this enrollment period. This change will go into effect the first month after the provider receives your change request.

Part D enrollment (special circumstances)

Running from April 1st through June 30th, you can enroll in a Part D plan if the following criteria are met:

You must pay a premium for Medicare Part A.
You enrolled in Part B during the general enrollment period.

If you do enroll in a Part D plan, your prescription drug coverage will begin on July 1st. However, you might have to pay a late enrollment penalty on your Part D premium for enrolling late.

Medigap OEP

Also known as Medicare supplement insurance, Medigap can help cover some out-of-pocket costs associated with Original Medicare. Lasting 6 months, the Medigap OEP begins if you meet the following criteria:

You’re aged 65 or older.
You’ve enrolled in Part B for the first time.

Medigap can only be used with Original Medicare. Those with Medicare Advantage plans cannot enroll in Medigap.

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Special enrollment periods (SEP)

There are certain times when you can make changes to your Medicare plans outside the enrollment periods mentioned above. These are called special enrollment periods. You’re eligible for a SEP if:

You didn’t sign up for Medicare when you were first eligible because you were covered under an employer-provided plan. (This includes coverage under a spouse or family member’s plan.)

You can enroll in Medicare at any time, whenever you’re covered by this plan or in the 8-month window after your employer-provided coverage ends. Fortunately, you typically don’t incur late enrollment penalties when you enroll during a SEP!

Medicare Advantage and Part D plans also have their own special enrollment periods. These are usually based on special circumstances, such as marriage or divorce.

Next Steps

Visit www.medicare.gov after October 1^st to view Medicare Part D and Medicare Advantage plans. And remember, enrollment starts on October 15th! There is a tool for helping you narrow your search for new Medicare Advantage and Prescription Drug plans. To use it, you can either:

Log in to your account to get a summary of your current coverage and use your saved drugs & pharmacies to compare plan costs.
OR continue without logging in and enter your zip code.

find medicare health & drug plans -- resource by medicare.gov — ^{Image Credit: Medicare.gov}

It’s wise to verify every year that your prescription drugs are covered on your Part D Medicare Prescription Drug plan. Medicare Advantage or Prescription Drug plans can change their prescription drug formulary each year, and if your prescriptions are not covered for the next year, you may have to pay 100% of that prescription out of your pocket if it is not covered on your Part D plan.