Annual Enrollment Period

Medicare Advantage AEP

This year, the Annual Enrollment Period (AEP) starts October 15th and ends on December 7th for a January 1st effective date.

Medicare Advantage (MA) plan options are limited by the county you reside in. These plans come as HMO, PPO and PFFS options. They are available with prescription drugs (MAPD), and without prescription (MA) benefits.

Annual Enrollment Period (AEP) is a specific time each year when you can change plans. During the AEP you can switch from one you switch from one plan to any other plan that is available in your county (as long as you do not have "final stage renal failure"). You can move from MAPD to MAPD, MA to MA, MAPD to MA and MA to MAPD. If you do not select a plan with prescription benefits (MA) at your enrollment, you will not be able to make a change until the next AEP to a plan which cover prescription drugs (MAPD). During the AEP you can also switch from a Medicare Supplement (Medi-Gap) plan with or without a Prescription drug plan (PDP) to an MA or MAPD plan. This is also the time where you can move from an MA or MAPD plan to a Medicare Supplement. To do this you will need to complete an application with a health questionnaire. AEP starts October 15th and ends on December 7th for a January 1st effective date. Other than this time, you would need to have a Special Enrollment Period (SEP) available to you.

AEP = Annual Enrollment Period: The time of year you can make plan changes.
PDP = Prescription Drug Plan: Qualified Medicare Part D Prescription drug plan.
MAPD = Medicare Advantage Prescription Drug plan: Health plan that includes a Part D RX plan.
MA = Medicare Advantage plan without prescription benefits: Health plan without a Part D RX plan.
SEP = Special Enrollment Period: A reason you can switch plans out of the AEP (i.e. You moved, you lost coverage from your employer, you received a low income subsidy (LIS).
PPO = Preferred Provider Organization: This is a type of provider network where you may or may not have a primary physician. You may or may not need a referral to see a specialist. You may seek care outside of your network, for a greater cost share of the treatment. In an Emergency all care is “in network”.
HMO = Health Maintenance Organization: type of provider network for a Health Plan where you have a Primary Care Physician and you must receive a referral to seek care from a Specialist. There is no out of network coverage. In an Emergency all care is “in network”.