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Preparing for Medicare’s Open Enrollment Period: 6 Tips for Getting the Best Coverage

Cindy George, MPH
Updated on January 2, 2024

Key takeaways:

  • Medicare’s open enrollment period lasts 7 weeks, lasting from October 15 to December 7 every year. During this period, people with original Medicare and Medicare Advantage plans can make changes to their coverage that will go into effect January 1.

  • It’s important to assess your health, medical, and prescription medication needs as well as your finances to see if it makes sense to switch, add, or drop coverage.

  • Start your research early. Even if you’re happy with your current coverage, it’s important to review your plan(s), because costs and benefits can change from year to year.

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Medicare’s open enrollment period lasts from October 15 to December 7 every year. During this time, you can make changes to your Medicare coverage for the plan year that starts the following January 1. If you have a Medicare Advantage plan, you can also make changes during the Medicare Advantage open enrollment period from January 1 to March 31 every year.

Starting your research as early as possible will put you in a much better position to make an informed decision about the future of your care and avoid unnecessary out-of-pocket costs. To get started, you can use the six tips below. These tips will help you assess your coverage needs, evaluate your current original Medicare or Medicare Advantage plan benefits, and decide if it makes sense to switch to a new health or prescription medication plan for the next coverage year.

1. Don’t miss your open enrollment period

Making changes during the 7 weeks of Medicare open enrollment — October 15 to December 7 — is very important, especially if you have original Medicare. If you have a Medicare Advantage plan, you’ll have another chance to switch, add, or drop coverage in the first 3 months of the year.

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If you miss either of these open enrollment periods, you may qualify for a special enrollment period, depending on the circumstances. A special enrollment period can be triggered by many situations, including:

  • Moving to an address outside of your Medicare Advantage plan’s service area

  • Losing your current coverage

  • Having a Medicare Advantage plan that changes its contract with Medicare

Beginning January 1, 2024, if you sign up for Part A and/or Part B because of a special circumstance in your life, you will have 2 months to:

  • Join a Medicare Advantage plan (with or without prescription medication coverage)

  • Join a Medicare Part D plan, if you want prescription medication coverage with original Medicare

  • Join a Medicare Part D plan if your medications aren’t covered by your Medicare Advantage plan 

Your coverage will start the first day of the month after the plan receives your request to join.

If you are turning 65, you will have a 7-month window around your birthday to join Medicare and avoid late enrollment penalties. You can have a late enrollment penalty for Part A, Part B, or Part D.

These penalties are not one-time fees. They are ongoing fees that are usually applied as long as you’re enrolled in Medicare, typically increasing your premiums on a permanent basis.

2. Collect the documents required for Medicare enrollment

If you are becoming eligible for Medicare for the first time because you’re turning 65, ensure you sign up as early as possible. You have a 7-month window for initial Medicare enrollment, which includes the 3 months before you turn 65, your birth month, and the 3 months after your birthday.

If you don’t meet the requirements for automatic Medicare enrollment, you can apply for Medicare online, in person, or by phone. You’ll need a few important documents

  • Your birth certificate or other proof of birth

  • Proof of U.S. citizenship or legal residence (if you weren’t born in the U.S.)

  • Social Security card if you’re already drawing benefits

  • Information about your current health insurance, including the type of coverage and effective dates of coverage

  • Proof of employment, if applicable (a copy of your W-2 form, for example)

  • U.S. military discharge papers, if you served before 1968

3. Think about if your Medicare plan fits your health needs

A lot can change in a year, including your health needs. While your plan may be an ideal match when you first enroll, that may not be the case if you change healthcare providers, need new benefits, or start taking certain medications.

Some reasons you might consider switching to a new Medicare plan are:

  • You have new health needs.

  • You don’t need a particular benefit anymore.

  • Your prescription medications have changed.

  • Your plan is no longer the most affordable option for you.

  • Your plan changes or removes some benefits.

You should also be aware that while Medicare Advantage plans are required to provide all of the same standard benefits included in original Medicare, the extra benefits offered may change from year to year. If you have Medicare Part D or Medicare Advantage, your plan is required to send you an Annual Notice of Change (ANOC) before October. You’ll want to review the ANOC thoroughly when you receive it to see how your costs and coverage may be different in the next plan year.

4. Consider if you need a Medicare supplement insurance (Medigap) plan

Medigap is another name for Medicare supplement insurance, which can be used to help pay for out-of-pocket costs such as coinsurance and deductibles. You need original Medicare (both Part A and Part B) to buy and keep a Medigap plan. Private companies sell Medigap plans, which carry letter names.

There are 10 standard Medigap plans — A, B, C, D, F, G, K, L, M, and N — but not all of them may be available in your state. Plans F and G also offer a high-deductible option in some states. Some plans cover foreign travel emergencies and stays at skilled nursing facilities, among other expenses.

Some people already have coverage that helps with out-of-pocket expenses through:

  • Retiree health coverage

  • Union coverage

  • Military or veterans coverage

  • Employer-sponsored insurance

If you don’t have secondary coverage, though, you should consider buying a Medigap plan. This Medicare tool can help you find a Medigap policy in your state. But if you have questions about the rules for purchasing a Medigap plan, you may want to talk to a State Health Insurance Assistance Program (SHIP) counselor.

5. Think about signing up for Medigap before you’re subject to medical underwriting eligibility questions

Similar to initial Medicare enrollment, there’s a one-time Medigap open enrollment period that lasts 6 months, starting the first month you have Medicare Part B and are at least age 65. There are a few reasons to join Medigap during this enrollment period:

  • You can enroll in any Medigap policy.

  • You will generally be offered better prices and more plans.

  • Insurance companies can’t use medical underwriting, or health testing, to deny you coverage based on preexisting conditions.

After this 6-month period, you may have fewer Medigap plan options, have to pay more for coverage, or be subject to medical underwriting.

6. Contact your State Health Insurance Assistance Program (SHIP) for help

If you need help weighing your Medicare options, SHIP counselors provide free, unbiased advice to Medicare-eligible people and their caregivers. You can get local help from a SHIP counselor in person or over the phone. You can also find answers to your Medicare questions by visiting www.medicare.gov or calling 1-800-MEDICARE (1-800-633-4227).

The bottom line

Medicare’s open enrollment period happens annually from October 15 to December 7. During these 7 weeks, you can switch, add, or drop coverage if you have original Medicare or a Medicare Advantage plan. 

You can prepare for Medicare open enrollment by assessing your healthcare and financial needs and reviewing your plan’s benefits for the coming year, including what medications are covered by your Part D prescription medication plan. If you need help reviewing your coverage options, contact a counselor with your State Health Insurance Assistance Program (SHIP) for free advice.

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Cindy George, MPH
Cindy George is the senior personal finance editor at GoodRx. She is an endlessly curious health journalist and digital storyteller.

References

Centers for Medicare & Medicaid Services. (2023). Original Medicare (Part A and B) eligibility and enrollment

Medicare.gov. (n.d.). Avoid late enrollment penalties

View All References (10)

Medicare.gov. (n.d.). Drug coverage (Part D).

Medicare.gov. (n.d.). Find a Medigap policy that works for you.

Medicare.gov. (n.d.). Get ready to buy.

Medicare.gov. (n.d.). Get started with Medicare

Medicare.gov. (n.d.). How do I buy a Medigap policy?

Medicare.gov. (n.d.). Joining a plan.

Medicare.gov. (n.d.). Special enrollment periods.

Medicare.gov. (n.d.). What's Medicare supplement insurance (Medigap)?

Medicare.gov. (n.d.). When does Medicare coverage start?

U.S. Social Security Administration. (n.d.). Sign up for Medicare.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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