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Medicare Annual Enrollment Period
October 15 - December 7 | Changes generally begin January 1

Do not let the Part D review window pass.
For most people with a stand-alone Medicare Part D plan, the fall Annual Enrollment Period is the main annual opportunity to change drug coverage for the upcoming year. A quick review of medications, pharmacies, and plan changes may help avoid unnecessary drug costs or coverage surprises.
What Is the Medicare Annual Enrollment Period?

The Medicare Annual Enrollment Period, commonly called Medicare Open Enrollment, is the fall window when people with Medicare can review certain health and prescription drug coverage choices for the upcoming year. It runs each year from October 15 through December 7. Changes made during this period generally begin January 1 of the next year, as long as the plan receives the enrollment request by December 7.

Why This Window Matters
Medicare plans can change every year. Premiums, deductibles, copays, provider networks, drug formularies, pharmacy pricing, star ratings, prior authorization rules, and plan benefits may all change from one year to the next. Your personal situation can also change. A new medication, a different dosage, a new doctor, a preferred pharmacy change, or a health diagnosis may affect which Medicare option works best for you.

The Key Message for Part D Prescription Drug Plans
For most people enrolled in a stand-alone Medicare Part D prescription drug plan, the fall Annual Enrollment Period is the main annual opportunity to change Part D coverage for the upcoming year. That makes the Part D plan review especially important. If a beneficiary lets the window pass, they may have to keep their current stand-alone drug plan for the next year unless they qualify for a Special Enrollment Period or another specific exception

Why a Part D Plan Review Can Save Money
Part D plans are not one-size-fits-all. A plan that worked well last year may not be the best fit next year. Drug plans can change their covered medication list, place drugs on different tiers, change pharmacy networks, alter mail-order pricing, or update restrictions such as prior authorization, quantity limits, or step therapy. Medicare and CMS encourage people to compare coverage because plan costs and covered benefits can change, and reviewing options may help beneficiaries find better coverage, save money, or both.

What Can Be Changed During Medicare Annual Enrollment?

Change from Original Medicare to a Medicare Advantage plan.
Change from a Medicare Advantage plan back to Original Medicare.
Switch from one Medicare Advantage plan to another Medicare Advantage plan.
Join, switch, or drop a Medicare Part D prescription drug plan.
Review a Medicare Advantage plan that includes prescription drug coverage.
Compare plan costs, benefits, pharmacies, provider networks, star ratings, and prescription drug coverage for the next year.

What Annual Enrollment Does Not Usually Do

It does not create a general guaranteed-issue window to buy or change a Medicare Supplement/Medigap policy.
It does not replace your Initial Enrollment Period when you are first eligible for Medicare.
It is not the same as the January 1 - March 31 Medicare Advantage Open Enrollment Period.
It does not mean everyone must change plans. It means everyone should review before deciding to stay or change.

Important: Fall AEP Is Not the Main Medigap Shopping Window

Many Medicare beneficiaries hear “Open Enrollment” and assume it applies to every type of Medicare coverage. That misunderstanding is especially common with Medicare Supplement Insurance, also called Medigap. The fall Annual Enrollment Period is very important for Medicare Advantage and Part D prescription drug plan decisions, but it does not usually give someone a new guaranteed right to change Medigap policies. Medigap is private insurance and is generally governed by federal Medigap protections, insurance company underwriting rules, and state-specific rules.
A client may be able to apply for a different Medigap policy during the fall, but that does not automatically mean the application will be accepted without medical underwriting. In many situations, changing a Medigap plan outside of a protected enrollment right can involve health questions, possible denial, or different carrier rules. That is why the fall AEP should not be presented as a universal Medigap shopping season.

Nevada Note: The Birthday Rule May Be a Better Medigap Review Window

For Nevada residents who already have a Medicare Supplement policy, the Nevada Medicare Supplement “Birthday Rule” may be a more practical time to review Medigap options. Under Nevada AB 250 guidance, existing Medicare Supplement policyholders receive a new open enrollment period starting on the first day of their birthday month and extending for at least 60 days after.
During this Nevada Birthday Rule window, an eligible policyholder may purchase a new Medicare Supplement plan with the same or lesser benefits from the current carrier or a new carrier without medical underwriting. This can make the birthday month review especially important for clients who want to compare Medigap premiums, carriers, or similar/lower benefit plan options.

Client-friendly takeaway:
Fall AEP is the key annual review window for Part D and Medicare Advantage. Medigap is different. In Nevada, many Medigap policyholders should remember their birthday month because that may be the better time to review Medicare Supplement options.

Simple Client Explanation: Government Medicare Plans vs. Private Medigap Policies
A helpful way to explain this to clients is that the fall Annual Enrollment Period mainly applies to the Medicare health and drug plan side of Medicare - Medicare Advantage plans and Medicare Part D
prescription drug plans. These are the areas where Medicare sets a yearly fall election window for changes that generally take effect January 1.
Medigap is different. Medicare Supplement Insurance, also called Medigap, is private insurance sold by insurance companies. Medigap policies work alongside Original Medicare, but they are not Medicare Advantage plans and they are not changed under the fall AEP in the same way Medicare Advantage or Part D plans are changed.
Because Medigap policies are private insurance products, the ability to change from one Medigap policy to another depends on Medigap rules, carrier underwriting rules, guaranteed issue rights, and state-specific protections. That is why fall AEP may or may not be the best time to review a Medigap policy.
​
For Nevada residents who already have a Medigap policy, the Nevada Birthday Rule can be especially important. In many cases, the birthday rule window may be a more useful time to compare Medicare Supplement options because it may allow an eligible policyholder to move to a same-or-lesser benefit Medigap plan without medical underwriting.

Client Reminder Box: What to Review and When

Fall AEP: Review Medicare Advantage and Medicare Part D drug plans for the upcoming year. This is especially important for stand-alone Part D plans because formularies, premiums, deductibles, drug tiers, and pharmacy pricing can change every year.
Medigap: Do not assume fall AEP automatically gives you a new right to change Medicare Supplement plans. In Nevada, ask about the Birthday Rule and whether your birthday month review may be a better time to compare Medigap options.
How to Explain the Difference to Clients
If you have a stand-alone Part D plan, do not miss the October 15 - December 7 Annual Enrollment Period because this is the main annual window to change your drug plan for the next year.
If you have a Medicare Advantage plan, the fall Annual Enrollment Period is the main annual window to compare Medicare Advantage options for the upcoming year.
If you have a Medicare Supplement/Medigap policy, the fall AEP may or may not be the best time to change. In Nevada, your birthday month review may be more important because of the Nevada Birthday Rule.

Part D Plan Review Checklist

1.Review your Annual Notice of Change: Your current plan sends information showing how benefits, premiums, drug coverage, and cost-sharing may change for the next year.
2.Update your medication list: Include exact medication names, dosages, frequency, and whether you use brand-name or generic medications.
3.Check pharmacy pricing: A preferred pharmacy, standard pharmacy, and mail-order option can produce very different drug costs.
​4.Compare total yearly cost: Look beyond the premium. Review deductible exposure, copays, coinsurance, tier placement, and estimated annual drug cost.
5.Review coverage rules: Check for prior authorization, quantity limits, step therapy, and formulary changes.
6.Make any change before December 7: If a plan change is needed, do not wait until the final day. The plan must receive the enrollment request by the deadline.

Common Part D Cost Mistakes During AEP

Assuming the same drug plan will have the same cost next year.
Only comparing monthly premiums and ignoring total estimated yearly drug cost.
Forgetting that one pharmacy may price the same drug differently than another pharmacy under the same plan.
Not checking whether a medication moved to a different tier or now requires prior authorization.
Ignoring the Annual Notice of Change from the current plan.

Waiting until December 7 to review options and running out of time to make a careful  decision.

FAQ: Medicare Annual Enrollment Period

When is the Medicare Annual Enrollment Period?
The Medicare Annual Enrollment Period runs from October 15 through December 7 each year. Plan changes generally become effective January 1 of the next year.

Is Annual Enrollment the same as Open Enrollment?
Many people use the terms interchangeably. Medicare.gov commonly refers to this fall window as Medicare Open Enrollment. Insurance professionals often call it the Annual Enrollment Period, or AEP.

What can I do during Annual Enrollment?
You can switch from Original Medicare to a Medicare Advantage plan, switch from a Medicare Advantage plan back to Original Medicare, change Medicare Advantage plans, join, switch, or drop a Medicare drug plan, or review Medicare Advantage plans that include drug coverage.

Can I change my stand-alone Part D drug plan during this period?
Yes. For most beneficiaries, October 15 through December 7 is the main annual window to change a stand-alone Medicare Part D prescription drug plan for the next calendar year. This is why an annual drug plan review is so important.

What happens if I miss the December 7 deadline?
In most cases, your current health or drug plan will continue into the next year if it is still available, including any changes to premiums, drug costs, benefits, formularies, pharmacies, and rules. You may not be able to make another change until a later enrollment period unless you qualify for a Special Enrollment Period.

Do I need to change plans every year?
No. Some people review their plan and decide to keep it. The important step is reviewing before the deadline, because keeping the same plan without checking drug costs and network details can lead to avoidable surprises.

Is the January-March Medicare Advantage Open Enrollment Period the same thing?
No. The January 1 through March 31 Medicare Advantage Open Enrollment Period is only for people already enrolled in a Medicare Advantage plan. It is not the same as the fall Annual Enrollment Period and does not generally give people with only Original Medicare and a stand-alone Part D plan another routine chance to shop Part D coverage.

Can Annual Enrollment change my Medicare Supplement plan?
The fall Annual Enrollment Period is mainly for Medicare Advantage and Medicare Part D plan changes. It does not usually create a general guaranteed-issue window to change Medicare Supplement/Medigap policies. A person may be able to apply for a different Medigap plan during the fall, but the application may require medical underwriting unless the person has a guaranteed right or qualifies under a state-specific rule. In Nevada, existing Medigap policyholders should also pay close attention to the Nevada Birthday Rule, which may provide a better annual review opportunity for certain same-or-lesser benefit Medigap changes.

Is fall Annual Enrollment the best time to change a Medigap plan in Nevada?
Not always. Fall AEP is the main annual decision period for Medicare Advantage and Part D. Medigap follows different rules. In Nevada, the Birthday Rule may be a better time for an existing Medigap policyholder to review options because it can allow a move to a same-or-lesser benefit Medicare Supplement policy without medical underwriting during the birthday rule window.

What is Nevada’s Medicare Supplement Birthday Rule?
Nevada’s Birthday Rule gives existing Medicare Supplement policyholders a new open enrollment period that starts on the first day of their birthday month and extends for at least 60 days after. During that window, eligible policyholders may purchase a new Medicare Supplement plan with the same or lesser benefits from their current carrier or a new carrier without medical underwriting.

Are Medigap plans part of the government Medicare program?
No. Medigap plans are private Medicare Supplement insurance policies sold by insurance companies. They help pay certain out-of-pocket costs under Original Medicare, but they are not Medicare Advantage plans and they do not follow the same fall Annual Enrollment rules as Medicare Advantage or Part D plans.

Why do many Nevada clients review Medigap during their birthday month instead of the fall?
For many Nevada Medigap policyholders, the birthday rule window may be more useful than the fall AEP because Nevada gives eligible existing Medicare Supplement policyholders a birthday-related window to move to a same-or-lesser benefit Medigap policy without medical underwriting. The fall AEP remains the key annual review period for Medicare Advantage and Part D.

What should I bring to a Part D plan review?
Bring your Medicare card, current plan information, a complete prescription list with exact drug names, dosages and frequency, your preferred pharmacies, and any notice from your current plan such as the Annual Notice of Change.

A local Medicare Specialist can help review plan changes, compare medications and pharmacies, explain plan trade-offs, and help you understand how different Medicare options may work in real life based on your doctors, prescriptions, budget, and location.

Final Closing Points
Medicare Annual Enrollment can be one of the most important Medicare review periods of the year, especially for Medicare Advantage and Medicare Part D prescription drug coverage. Even if you are happy with your current coverage, it is wise to review your plan before the deadline. However, Medigap is different. Medicare Supplement policies are private insurance plans and are not changed under the fall AEP in the same way. Nevada residents with Medigap coverage should also ask whether the Nevada Birthday Rule may be the better time to compare Medicare Supplement options.

Medicare in Las Vegas helps Nevada residents review Medicare Advantage, Medicare Supplement, and Medicare Part D prescription drug plan options in clear, practical language.
For local Medicare guidance, contact:
David Karel, Nevada Licensed Insurance Agent License #210603, at 702.403.6348 (TTY: 711)
or visit www.medicareinlasvegas.com.
Representing many of the Private Insurance companies that sell:
Medicare Advantage Plans, Medicare Part D and Medigap Supplemental Insurance
We are licensed in the following states as an Insurance Marketing Group:
*Nevada #210603 *Arizona License #2147056 *Utah License #234923 *Idaho 773252 *California #4053866 *Oregon 2147056,*Washington State 919217 *Texas #1873256 *New Mexico 2147056



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