Medicare Part D Plan Fall Open Enrollment usually runs between October 15 – December 7. All new coverage begins the following year on the 1st of January. During this open enrollment you can change your plan as often as needed to get a feel of which plan works best for your needs, but know that the last choice you make before the 1st of January will be the plan that will go into effect.

If Medicare Plan D makes changes to its formula and certain Rx drugs are removed mid year, your plan will still cover these drugs until the end of the year, unless a generic form of that drug is now available. There is no SEP coverage that will take effect if your plan stops covering the drug you need.

If you are a member of the Medicare Advantage Plans, you will be able to change the Part D coverage of your plan during the Medicare Advantage Open Enrollment Period which is the 1st of January through March 31st. To do this and change your Rx drug coverage, you will have to dis-enroll out of the Medicare Advantage Plan you are currently in, and re-enroll into another Advantage Plan that has this prescription drug coverage or into a regular Medicare Plan with Plan D coverage. Changes that you make during the open enrollment period will go into effect at the beginning of the following month. Remember if you are trying to keep your Medicare Advantage Plan do NOT use this open enrollment as it will change your plan.

In some cases you can use the (SEP) or Special Enrollment Period to make changes to your Part D Medicare coverage plan. Below are some of the cases in which this is sometimes allowed.

You become eligible for a Special Needs Plan.

You enroll or fail to enroll due to not fault of your own such as a Federal Employees mistake.

You lose the Extra Help on your plan.

There is a “5 Star” plan in your service area you would like to join.

You move out of the Part D plans area of services.

The loss of the Creditable Coverage through no fault of your own.

Making changes to your job based Rx coverages.

You now reside in a qualifying medical institution.

Inadequate information received about your existing Rx coverage.

Being misled about the benefits you will receive.


See below for a full list of requirements and Special Needs Plan

Complete list of the Special Needs Plan Chart

To switch out of one plan into another you will want to call 1-800-Medicare and enroll without dis-enrolling out of your other. This process of dis-enrolling will automatically take place when your new plan begins. Try and always at the beginning of the enrollment period so that no gaps occur and there is no uncovered period of time.