What If I Missed Medicare Part D's Open Enrollment Period?
If you’re enrolled in Medicare, you know that you can sign up for your Part D Drug Plan during the open enrollment period.
The open enrollment period is October 15-December 7 every year.
But… what happens if you missed the open enrollment period?
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:
- You’re turning 65 and are newly eligible for Medicare Part B
- You qualify for a special enrollment period
What are special enrollment periods?
A special enrollment period 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, you would be able to choose a drug plan outside of the open enrollment period.
Another example is if your Medicare Advantage plan gets terminated. Other special enrollment periods can include a change of address that renders your current health insurance out-of-network, you weren’t properly told that your private drug coverage wasn’t as good as Medicare’s, and so on.
You can read all 25 special enrollment periods on Medicare’s official government website.
What happens if I miss the Part D open enrollment?
If you miss the open enrollment window, and you don’t qualify for a special enrollment… you’re out of luck 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.
For example, if you go, say, 31 months without a drug plan when you could have had one, you’d be penalized 31% on your future premium.
To help you understand how this would affect your drug costs, we’ll give an example.
The national base premium for 2018 is $35.02 (Medicare.gov). Your penalty would be 31%, or $10.86. That means you would pay $10.86 in addition to your plan’s monthly premium for not having a drug plan for 31 months.
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.
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