What If I Missed Medicare Part D's Open Enrollment Period?

If you’re enrolled in Medicare, you can sign up for your Part D Drug Plan during Medicare's open enrollment period, which lasts from October 15-December 7 every year. But… what happens if you missed the open enrollment period?

Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Perhaps you don’t have a drug plan at all, or you didn’t switch to a more desirable plan for one reason or another.

There are only 2 ways that you can enroll in a drug plan outside of the October 15-December 7 open enrollment period:

1. You’re turning 65 and are newly eligible for Medicare Part B
2. You qualify for a special enrollment period

What Are Special Enrollment Periods?

A Special Enrollment Period (SEP) is a circumstance, such as a life event, that allows you to make changes to your health or drug plan outside of the normal window.

There are 25 special enrollment periods total, but we tend to see a few of them quite often.

For example, if you got kicked off of your employer’s group plan or if your Medicare Advantage plan terminated. Other SEPs can include a change of address that renders your current health insurance out-of-network or if you weren’t properly told that your private drug coverage wasn’t as good as Medicare’s.

You can read about all 25 Special Enrollment Periods on Medicare’s official government website.

Related: When Does Medicare Start?

What Happens If I Miss the Medicare Part D Open Enrollment?

If you miss Medicare's open enrollment window (Oct. 15-Dec. 7), and you don’t qualify for a special enrollment, you have to wait until next year’s open enrollment period.

There is also a penalty for missing the open enrollment period. The penalty is 1% of the national base average premium per month that you don’t have a drug plan when you could have had one. That sounds like a lot of mumbo jumbo, but in layman's terms, that's about 33 cents per month that you go without creditable coverage.

To make it even easier, Amplicare, a Part D plan comparison tool for pharmacies, has created a penalty calculator. Input your date of birth, and it'll tell you how much you'll be penalized on your future monthly premium.

If you only missed one open enrollment period, you’ll only be penalized for 9-10 months, which should only add a few dollars to your Part D premium.

Here at Medicare Allies, we can help you determine if you need a drug plan, which drug plan is the best plan for you, and we’ll also help you avoid expensive penalties if we can.

Related: How Do I Find the Best Medicare Part D Drug Plan?

What Should I Do After Medicare's Enrollment Period Ends?

Once the Medicare enrollment period is over, it’s a great time to take a look at your overall financial plan.

• Are you happy with your health insurance?
• Is your life insurance up-to-date?
• Have you rolled over your retirement accounts such as a 401(k) or IRA?

These are all things we can help you with to give you peace of mind and security that your retirement is going as planned. Plus, the beginning of the year is a great time to meet with us!

The enrollment period in the fall is the busiest time of the year for insurance agents, but the beginning of the year through March is much slower. This gives us extra time to make sure your overall financial and retirement plans are fully taken care of.

If you have any questions about your Medicare Part D drug plan, the enrollment period, or next steps, call us at 833-801-7999. You can also connect with us by filling out a short form. We can’t wait to serve you.