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Medicare Part D Enrollment Periods

Just like with Medicare Advantage plans, if you want to enroll in a Part D drug plan, or switch to another one, you must have an enrollment window. We’ll cover those enrollment windows in this article.

When to Get Part D

The opportunities to enroll in a Medicare Part D plan are almost exactly the same as with Medicare Advantage. In fact, the only different between the two is that Medicare Advantage has an additional enrollment window called “Open Enrollment Period” or OEP that runs from January 1 through March 31. This enrollment period is not available for Part D Prescription drug plans.

The following are the enrollment windows where you can enroll in Part D:

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Initial Enrollment Period (IEP)

When you start Medicare Part B, you’ll have an Initial Enrollment Period where you can sign up for a Part D Drug Plan. This period runs for 3 months before your Part B start date and 3 months afterwards. 

Annual Election Period (AEP)

For most enrollees, this is their only opportunity to make a change to their Medicare Part D Drug plan for the next calendar year. The Annual Election Period runs from October 15 to December 7th of each year. All plans submitted during AEP will start January 1st. 

If you are switching from one Drug Plan to another, there is no need to cancel your existing coverage. The act of submitting a new plan will replace the other automatically on January 1st.

The Difference Between Advantage and Part D enrollment periods
All the enrollment periods are the same, except that you are NOT able to switch Drug Plans during the OEP which runs from January 1 – March 31. This is only for Advantage plans.

Special Election Periods (SEP)

Outside of the two main enrollment periods (AEP and IEP), there are Special Election Periods available during certain circumstances. 

Here are the 2 most common SEPs:

Moving out of the plan service area

One of the criteria to be eligible for a Part D plan is to live within the plan’s service area. If you move down the street while staying in the service area of your plan, you don’t need to do anything. However, if you’re on a Drug Plan in Seattle, Washington and you decide to move to Miami, Florida, this will put you out of the service area on your existing plan. You will receive an SEP which will allow you to enroll in a new plan that has coverage in your new location, without you having to wait for one of the main enrollment periods.

Receiving the Low Income Subsidy (LIS)

If your income & assets are below a certain threshold, you may qualify for the Low-Income Subsidy program that helps cover Part D prescription drug plan premiums and co-pays. Another benefit of being eligible for this is that you also get an SEP to make changes to your plan outside of the main enrollment periods. 

Enrollees with LIS can make one change to their Medicare Advantage plan during each of the first quarters of the year: January-March, April-June, July-September.

Receiving LIS aka “Extra Help” is Incredibly Helpful if you qualify
Checkout our page on the Low Income Subsidy program. If your income and assets are below a certain limit, you get some really great benefits for your Part D coverage.

FAQs

I don't like my drug plan, when can I switch?

Unless you recently moved or qualify for the LIS program, you’ll have to wait to switch drug plans during the AEP from October 15 – December 7th. Your new plan will start January 1st. 

Summary

There are only certain times of the year that you are able to change your Part D Drug plan. Mark your calendar and be sure not to miss them because you could be stuck with your current plan for a whole additional year!

Sylvia Gordon, aka Medicare Mama®, is an expert on all things Medicare and Social Security. She is the 2nd Generation here at The Medicare Family and has served on the advisory boards of major insurance companies like UnitedHealthcare®, Cigna, and Anthem. In her free time, she can be found taking care of her animals (dogs, goats, peacocks, chickens), and reading a good book. Learn More.
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