# December, 26, 2019

Missed Medicare Annual Enrollment? There’s Still Hope!

You saw all the mailers, the TV ads, all the online information, but somehow you still managed to forget the Medicare Annual Enrollment Period (AEP). And now you’re wondering: What will happen to your Medicare coverage? Not to worry. Even if you missed Medicare Annual Enrollment, you may still be able to make changes before next year’s AEP.

First Things First: Will You Still Have Coverage in 2020?

Yes, if you missed Medicare Annual Enrollment, you still have coverage in 2020. Your current coverage simply rolls over to next year.

If you’ll still have coverage, you may wonder why we push AEP so hard. The answer is simple: Plans change from year to year, sometimes substantially. Doctors leave networks, drug formularies change, options expand, prices go up and down. That’s why a plan that was great for you this year may not be the best choice next year.

The Medicare Advantage Open Enrollment Period

Starting January 1, beneficiaries who are currently enrolled in a Medicare Advantage (MA) plan may make changes during the Medicare Advantage Open Enrollment Period.

Changes you can make during Medicare Advantage Open Enrollment:

  • Change to a new MA plan (with or without prescription drug coverage)
  • Leave your MA plan to return to Original Medicare (Parts A and B)
  • If you return to Original Medicare, you may also enroll in in a Part D prescription drug plan

Changes you cannot make during Medicare Advantage Open Enrollment:

  • Leave Original Medicare to join an MA plan
  • Join a Part D plan if you have Original Medicare
  • Change from one Part D plan to another if you have Original Medicare

You have until March 31 to act. Any changes you make become effective on the first day of the following month.

Qualifying for a Special Enrollment Period

Medicare offers Special Enrollment Periods (SEPs) for those who meet certain qualifications known as special circumstances. There are literally dozens of ways to qualify for an SEP. The general categories, though, are as follows:

  • Your address changes
  • You lose your current coverage
  • You have the opportunity to get creditable coverage
  • Your current plan’s Medicare contract changes

How to Qualify for a Medicare Special Enrollment Period

Other miscellaneous qualifying circumstances include:

  • Becoming eligible for both Medicare and Medicaid
  • Qualifying for Extra Help
  • Being diagnosed with a condition that qualifies you for a Special Needs Plan – or no longer having that condition
  • Your plan failing to notify you that coverage was ending or changing

For each qualifying life event, you get at least two full months to make changes to your Medicare coverage without incurring a late penalty. Some special circumstances give you more time but again, there are dozens of them. Please refer to the above link for complete information about Special Enrollment Periods.

Are You Newly Eligible for Medicare?

If you weren’t already enrolled in Medicare when Annual Enrollment began, you couldn’t participate even if you wanted to. However, you still have two options to get Medicare coverage in 2020. Which option you choose depends on when you became eligible for Medicare.

The Initial Enrollment Period

Your Initial Enrollment Period (IEP) lasts a full 7 months. It begins three months before the month of your birthday and ends three months after your birth month.

While changes made during AEP take effect on January 1, your coverage start date varies under the IEP.

  • If you sign up during the 3-month window before your birthday, coverage begins the first day of the month you turn 65. If your birthday IS the first day of the month, coverage begins the month prior.
  • Signing up the same month you turn 65 means your coverage begins the month after your birth month.
  • If you enroll the month after your birthday, coverage begins two months later.
  • Signing up during month six or seven gets you a coverage start date three months after you enroll.

Our Medicare 101 post is a great starting point for anyone new to the Medicare program.

The Medicare General Enrollment Period

If you missed your IEP and don’t qualify for a Special Enrollment Period, the General Enrollment Period (GEP) is available.

General Enrollment occurs every year between January 1 and March 31. You can do all the same things you could have during your IEP. However, your coverage will not begin until July 1.

Depending on how long you delayed enrollment, you may owe late penalties. These may be substantial, which is why it’s so important to sign up for Medicare during your IEP if you do not qualify for a Special Enrollment Period.

Medicare Part A Late Penalties

Most people don’t pay a monthly premium for Part A. However, if you did not pay Medicare taxes for the required 40 quarters (i.e. 10 years), your premium is $437 in 2020 ($252 if you worked at least 30 quarters).

Your penalty is 10 percent for twice the number of years you delayed signing up.

  • 12 months = 10 percent penalty for 2 years
  • 24 months = 10 percent penalty for 4 years

And so on. Again, you only owe this penalty if you don’t qualify for premium-free Part A.

Medicare Part B Late Penalties

As with Part A, the Part B late penalty is based on your monthly premium. Unlike Part A, however, you pay this late penalty for the entire time you have Part B.

Part B’s late penalty is 10 percent for every full 12-month period that you delayed enrollment.

  • 12 months = 10 percent
  • 24 months = 20 percent

And so on. The standard Part B premium in 2020 is $144.60.

Medicare Part D Late Penalties

The Part D penalty is a bit different. You owe it any time you go 63 days or more without having creditable prescription drug coverage. Like Part B, though, you pay this penalty for the entire time you have Medicare Part D.

Part D’s penalty is 1 percent of the national base beneficiary premium times the number of months you went without coverage. That number is then rounded to the nearest dime. The calculation for 2020 looks like this:

Medicare Part D Late Enrollment Penalty Calculation

Conclusion

If you missed Medicare Annual Enrollment, you may still be able to make changes if you have a Medicare Advantage plan or qualify for a Special Enrollment Period.

Our Find a Plan tool lets you begin comparing your plan options. Just enter your location and coverage start date.

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Chris Gasparini

Chris Gasparini has been a licensed insurance agent since 2005. He enjoys helping Medicare beneficiaries navigate their options to find the best solution for their unique needs. Chris feels as though his work truly helps people. Because he represents multiple insurance companies and plan types, Chris is able to help Medicare beneficiaries find the best, most cost-effective plan. Every day, he leaves work knowing he did what was right for each and every client he serves.

The MedicareUSA website is operated by HealthPlanOne, LLC a licensed health insurance agency based in Connecticut; in California d/b/a HPOne Insurance Agency, license #OF30784. HealthPlanOne, is a licensed and certified representative of Medicare Advantage HMO, PPO and PPFS organizations and stand-alone prescription drug plans with a Medicare contract. Enrollment in any plan depends on contract renewal.

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Last Updated 12/21/2018