The Annual Enrollment Period: October 15– December 7

By Mike Miligi, Certified Medicare Insurance Planner – Michael M Insurance Services
What it is, what you’re allowed to change, and what to watch for before you pick up the phone or sign anything.
Once a year, for seven weeks, Medicare hands every enrollee a rare thing: a no-questions-asked chance to change their mind. That window is the Annual Enrollment Period, or AEP, and it runs from October 15 through December 7 every year. Whatever you decide during that window takes effect January 1.
If you already have a plan you’re happy with, you technically don’t have to do anything — your coverage will simply continue. But “doing nothing” should be a decision you make on purpose, not a default you fall into. A lot can change in a year: your health, your medications, your doctors, even the plan itself. This guide walks through what AEP actually covers, what’s worth reconsidering, and how to steer clear of the scams that flood mailboxes and phone lines every fall.

What Is the Annual Enrollment Period?

AEP is the one stretch of the year when nearly anyone on Medicare can make changes to their coverage without needing to qualify for a special exception. It applies if you’re enrolled in Original Medicare, a Medicare Advantage plan, or a standalone Part D drug plan. During these seven weeks, you can:
  •  Switch from Original Medicare to a Medicare Advantage plan, or the other way around
  • Switch from one Medicare Advantage plan to a different one
  • Join a Part D prescription drug plan for the first time, if you didn’t enroll when you were first eligible
  • Switch from one Part D plan to another
  • Drop a Part D plan altogether, if you no longer need one
Every change made during AEP takes effect on January 1 of the following year, regardless of whether you make the change on October 16 or December 6.

One important exception: Medicare Supplements

AEP does not guarantee your right to buy or switch a Medicare Supplement (Medigap) policy. Outside of your initial 6-month enrollment window or a qualifying event, insurers in most states can ask health questions and decline coverage or charge more based on your health. Rules on this vary meaningfully by state — some states offer broader guaranteed-issue protections than others — so this is one area worth checking against your specific state’s rules before assuming you can switch freely.

What You Can Actually Do, Plan by Plan

Medicare Advantage

Medicare Advantage (Part C) plans are offered by private insurers as an alternative to Original Medicare, usually bundling in Part D drug coverage and often extra benefits like dental, vision, or hearing. AEP is your opportunity to compare this year’s plan offerings against what you’re enrolled in now. Insurers are allowed to change a plan’s costs, drug formulary, provider network, and extra benefits every single year — so a plan that fit perfectly in January can look quite different by the following fall.
Worth checking each year: your monthly premium, your annual out-of-pocket maximum, copays for the specialists you actually see, and whether your pharmacy and hospital network has changed.

Medicare Supplements (Medigap)

Medigap policies work alongside Original Medicare to cover cost-sharing gaps — deductibles, copays, coinsurance. Unlike Medicare Advantage, Medigap plans are standardized by letter (Plan G, Plan N, and so on), so the benefits of a given plan letter are the same no matter which insurer sells it. That means shopping for a better rate on the same plan letter can genuinely save money — but as noted above, medical underwriting may apply if you’re switching outside a protected window. This is a good example of something that’s worth a direct conversation before acting.

Part D (Prescription Drug Coverage)

Part D plans update their drug formularies, tiers, and pharmacy networks annually — often significantly. A medication that was a low copay tier last year can move to a higher tier, or drop off the formulary entirely, without much fanfare. This is one of the most commonly overlooked reasons people end up overpaying for the exact same prescriptions they’ve taken for years.

Before You Decide: Ask Yourself These Questions

Rather than starting with “which plan is best,” it’s usually more useful to start with what’s changed in your own life since last year:

Questions to Ask

  • Have your doctors changed? If you’ve added a specialist, moved, or your primary care provider retired, confirm they’re still in-network before assuming your current plan still works for you.
  • Have your medications changed? New prescriptions, dosage changes, or a switch from brand-name to generic can all shift what you pay under a given plan’s formulary.
  • Has a new or chronic condition developed? A new diagnosis this year — diabetes, a heart condition, a mobility issue — may mean a plan with a lower out-of-pocket maximum, better specialist access, or added benefits like transportation is now worth far more to you than it was.
  • Has your plan’s cost or network changed for next year? Your current insurer will mail you an Annual Notice of Change each September. It’s easy to set aside, but it’s the single most useful document for deciding whether to stay put.
  • Are you still using the extra benefits you’re paying for? Dental, vision, fitness memberships, and over-the-counter allowances vary widely by plan — it’s worth confirming you’re actually using what you have.

If nothing has changed

It’s still worth a quick review of your Annual Notice of Change letter, since the plan itself may have changed even if your health hasn’t.

Watch Out: This Is Prime Season for Bad Actors

Every fall, the volume of Medicare-related robocalls, direct mail, and cold calls spikes sharply — and a meaningful share of it is designed to mislead rather than inform. A few patterns worth knowing:

Common red flags during AEP

  • Unsolicited phone calls from an 800 number claiming to be “from Medicare” or a call center offering to “review your benefits.” Medicare itself does not call enrollees to sell plans.
  • Robocalls with urgent language like “your benefits are changing” or “you qualify for a free grocery card” that push you to press a number or stay on the line.
  • Direct mail designed to look official — using seals, government-style typography, or envelope language like “URGENT: Respond by deadline” to mimic a Medicare or Social Security mailing.
  • High-pressure enrollment tactics, including being rushed to enroll on the spot without time to compare plans or ask questions.
  • Requests for your Medicare number or banking details over the phone from someone who called you, rather than someone you called.
A simple rule of thumb: legitimate agents and plans are allowed to market to you, but they are not allowed to cold-call you without your prior consent, and Medicare itself will never call you uninvited to sell you anything. If you didn’t initiate the contact, treat it with caution — hang up, set the mailer aside, and reach out to someone you already trust to verify before acting.

AEP vs. Other Enrollment Windows

AEP often gets confused with two other periods:
  • Medicare Advantage Open Enrollment Period (Jan 1 – Mar 31): A narrower window where those already in a Medicare Advantage plan can make one switch to a different MA plan or back to Original Medicare.
  • Special Enrollment Periods (year-round, situational): Triggered by specific life events — moving, losing other coverage, qualifying for Medicaid — and available anytime they apply, not just in the fall.

Quick Questions, Straight Answers

What happens if I don't do anything during AEP?
Your current plan automa cally con nues into the new year. That’s fine if your costs and coverage haven’t changed — but it’s worth confirming that’s actually true rather than assuming it.
Yes. AEP works in both direc ons — from Medicare Advantage into Original Medicare, or from Original Medicare into a Medicare Advantage plan.
Every change made during AEP takes effect January 1, whether you enroll on October 16 or December 6.
You can request a change any me of year, including during AEP. But outside your original enrollment window or a qualifying event, most states allow insurers to ask health ques ons and poten ally decline coverage or charge more — unlike Medicare Advantage and Part D, which don’t require underwri ng during AEP.
Yes, AEP is open enrollment for Part D too. Keep in mind that if you’ve gone 63 days or more without creditable drug coverage since you first became eligible, a late enrollment penalty may apply and stay a ached to your premium going forward.
No. Switching plans during AEP is exactly what the window is for and carries no penalty. Penal es relate to delays in ever enrolling in coverage, not to switching once you’re already enrolled.
Check the plan’s formulary for the upcoming year, not the current year’s — formularies are updated annually and typically posted before AEP begins. A pharmacist or the plan’s member services line can also run a coverage check against your medica on list.
AEP (Oct 15–Dec 7) is open to anyone on Medicare and allows the widest range of changes. The Medicare Advantage Open Enrollment Period (Jan 1–Mar 31) is only for people already in a Medicare Advantage plan, and allows just one addi onal switch.
Medicare will not call you unsolicited to sell a plan, and legi mate agents can’t cold-call you without documented prior permission. If you didn’t ini ate the contact, verify independently before sharing any personal informa on — look up a number yourself rather than using one provided in the mailer or call.
It’s not required, but a quick annual review is worth the ten minutes it takes — plan costs and coverage can change year to year even when your health hasn’t.
Choosing between Medicare Supplement and Medicare Advantage — and picking the right Medigap plan if you go that route — comes down to your health needs, your budget, and how much you value flexibility over a lower monthly premium. I’ve spent over 10 years helping individuals work through exactly this decision, and I’m a Medicare beneficiary myself, so I understand these choices firsthand. If you’d like help comparing your specific op ons in Babylon, give me a call. That conversa on is always free
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Mike Miligi

Owner, Michael M Insurance Service

For over 10 years, Mike has helped seniors and other Medicare-eligible individuals understand their options, including
Medicare Advantage Plans (Part C), Medicare Supplement Plans (Medigap), Prescription Drug Plans (Part D), and dental
and vision programs. Mike is licensed in seven states and certified with 11 insurance carriers. As an independent
Medicare health insurance broker, he works for the client, not the insurance carriers, providing accurate, unbiased
options. Mike recertifies with CMS annually and completes continuing education to stay current on industry standards.

(631) 774-3786 | mmilinsurance@gmail.com | www.mymedicaremike.com

RELATED TOPICS-
Guide to Your Medicare Card | What It Covers – Michael M
Medicare Supplement (Medigap) Plans NY | Quote – Michael M
Medicare Advantages Plans – Michael M Insurance Services
Medicare Part D – My medicare mike

INFO SOURCES-
www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan
Medicare vs. Medicare Advantage Open Enrollment
Medicare Open Enrollment | CMS
medicareadvocacy.org/medicare-annual-enrollment-period-lasts-through-december-7/

Related Articles

Choosing the Right Medicare Coverage

Selecting the best Medicare coverage depends on factors like your healthcare needs, budget, and preferred providers. You can choose between:
  • Original Medicare (Parts A & B): Allows you to see any doctor or
    hospital that accepts Medicare but does not include prescription drug
    coverage (Part D) or additional benefits.
  • Medicare Advantage (Part C): Offers bundled coverage with
    potential extra benefits but may require using a network of providers.
  • Medigap (Medicare Supplement Insurance): Helps cover
    out-of-pocket costs not covered by Original Medicare, such as
    copayments and deductibles.

Key Medicare Enrollment Periods

It is crucial to enroll in Medicare at the right time to avoid penalties and ensure continuous coverage:
  • Initial Enrollment Period (IEP): A seven-month window starting
    three months before your 65th birthday month.
  • General Enrollment Period (GEP): From January 1 to March 31
    each year for those who missed their IEP.
  • Annual Election Period (AEP): From October 15 to December 7,
    allowing you to switch or enroll in Medicare Advantage and Part D
    plans.
  • Open Enrollment Period(OEP): From January 1 to March 31 for
    those who missed AEP and want to make certain changes.
  • Special Enrollment Period(SEP): Can be used anytime during the
    calendar year for those that meet certain criteria such as moving to a
    new service area.

Finding Help with Medicare

Understanding Medicare can be complex, but you don’t have to do it alone. Licensed Insurance Brokers, Medicare.gov, and state health assistance programs can provide guidance tailored to your specific needs.
By taking the time to explore your Medicare options, you can make informed decisions that ensure you receive the healthcare coverage that best suits your lifestyle and budget.
Do I have to sign up for Medicare?
It depends upon your current coverage. If you are employed and your employer has over 20 employees then you can delay signing up for Medicare and avoid penalties.
No, You will have to enroll in a stand alone Part D plan or a Medicare Advantage Plan(Part C) to get coverage.
There are no networks with Medicare and most doctors and hospitals accept it. However, Medicare does not cover 100% of services so a Medicare Supplement or Medicare Advantage plans is advisable.

Mike Miligi- Owner

For over 10 years, Mike has been assisting Seniors and other Medicare-eligible individuals in understanding the ins and outs of Medicare and Medicare Health Insurance options, including Medicare Advantage Plans(Part C), Medicare Supplement Plans(Medigap), Prescription Drug Plans(PartD), and Dental and Vision programs.
Mike is Licensed in seven States and Certified with 11 Insurance Carriers. He has helped thousands of individuals decide on the best course of action for their particular Health Insurance needs. Because Mike is an Independent Medicare Health Insurance Broker, he works for the client, not the Insurance Carriers, and is able to provide his clients with accurate and unbiased Health Insurance options.
Mike recertifies with CMS(The Centers for Medicare and Medicaid Services) annually, regularly completes Continuing Education Courses required by individual State Insurance Departments, and keeps abreast of industry trends and standards to offer his clients the most up-to-date information.
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