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Reviewing Your Plan Mid-Year vs. AEP

  • Writer: Cassidy Clark
    Cassidy Clark
  • 5 days ago
  • 2 min read

Many people believe October is the only time they can think about their Medicare coverage. This is a common misconception, and reviewing your plan mid-year can ensure your coverage is always what you need.


The Annual Enrollment Period (AEP) only applies to Medicare Advantage Plans and Part D Prescription Drug Plans, while Medicare Supplement plans can be changed at any time. 


When Can You Make Changes Outside of AEP?


Special Enrollment Periods (SEPs): Certain life events open a window to make changes mid-year, including:


  • Moving out of your plan's service area

  • Losing other coverage such as employer, union, or Medicaid coverage

  • Qualifying for or losing Extra Help (Low-Income Subsidy) for Part D

  • Moving into or out of a long-term care facility

  • Your plan losing its Medicare contract or significantly cutting its benefits


5-Star Special Enrollment Period:


  • If a Medicare plan in your area has earned a 5-star quality rating, you have a one-time opportunity each year to switch to it outside of AEP

  • This period runs December 8 through November 30 of the following year


What if None of Those Apply to You?


A mid-year review is still worthwhile even if you cannot make changes right now. Use the summer months to:


  • Confirm your doctors are still in-network

  • Check that your medications are still on your plan's formulary and at the same cost tier

  • Think about whether any health changes this year will affect your needs going into the fall

  • Be ready when AEP opens October 15, so you are not making decisions under pressure

  • Secure your appointment with SGIA Medicare Consulting during AEP now to review your coverage and make any needed changes


The Annual Enrollment Period (AEP) runs October 15 – December 7 each year. Any changes you make take effect January 1. But the time to prepare is now, not October 14.

SGIA Medicare Consulting is available year-round to help you review your plan and be ready when the right window opens. Call us at 888-284-3314 or visit our website sgiamedicare.com.

 
 
 

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