🖋️ 2025 Medicare Annual Election Period (AEP) — Comprehensive FAQ

Coverage Effective January 1, 2026

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Mary Lee Medicare Education 2026

🗓 AEP Overview

The Medicare Annual Election Period (AEP) is when beneficiaries can change how they receive Medicare coverage.
AEP 2025 runs October 15 – December 7, 2025, and all changes take effect January 1, 2026.

1️⃣ What is the Medicare Annual Election Period (AEP)?

• Switch between Original Medicare (Parts A & B) and a Medicare Advantage (Part C) plan.
• Join, switch, or drop a Medicare Prescription Drug (Part D) plan.

For the 2025 AEP (coverage effective Jan 1 2026), you can review and update your plan to fit your health and budget.

2️⃣ What can I do during the AEP?

• Move from Original Medicare to Medicare Advantage or back again.
• Change from one Advantage plan to another.
• Join, switch, or drop a Part D drug plan.

These options help you adapt coverage to your current needs.

3️⃣ Why is reviewing my plan each year important?

Plans change every year. For 2026:

• Annual Part D out-of-pocket cap: $2,100 (↑ from $2,000). After reaching that limit, you pay $0 for covered drugs for the rest of the year.
• Standard Part D deductible: $615.
• Catastrophic coinsurance: 5 % elimination continues (initiated in 2024).
• Prescription Payment Plan: available nationwide Jan 1 2026 — lets you spread costs monthly.
• Drug Price Negotiation: first 10 Medicare-negotiated drug prices begin Jan 1 2026.

4️⃣ What if I miss the AEP deadline?

• Move to a new service area,
• Lose employer or union coverage, or
• Have your plan end its Medicare contract.

You may qualify for a Special Enrollment Period (SEP) under these circumstances.

5️⃣ What’s the difference between AEP and the Medicare Advantage Open Enrollment Period?

2026 cost trends: Average MA-PD premium ≈ $14/mo (down from $16); max in-network out-of-pocket limit → $9,250 (down from $9,350).

6️⃣ How do I know if my plan is changing for 2026?

Your plan must send an Annual Notice of Change (ANOC) by the end of September. Compare your ANOC with other available plans during AEP to ensure you have the best fit for 2026.

7️⃣ How do I compare plans effectively?

1. Review your ANOC and current benefits.
2. List your prescriptions and preferred doctors.
3. Use the Medicare.gov Plan Finder tool.
4. Check Star Ratings (5 stars = highest quality).
5. Contact Mary Lee for personalized guidance and plan comparison.

8️⃣ What happens after I enroll or change plans?

Your new coverage starts January 1, 2026. Keep both old and new plan cards until you receive confirmation from your new plan.

9️⃣ How can I control my prescription costs in 2026?

• Out-of-Pocket Maximum: $2,100 for 2026 – after that, $0 cost-sharing.
• Standard Deductible: $615.
• Prescription Payment Plan: available nationwide Jan 1 2026.
• Extra Help Program: continues in 2026 with no premium, no deductible, and copays of $4.90 (generic) / $12.15 (brand).
• Negotiated Drug Prices: first 10 take effect Jan 1 2026.

🔟 How can I get help or unbiased advice?

• Medicare: 1-800-MEDICARE (1-800-633-4227)
• Social Security Administration (Extra Help): 1-800-772-1213
• State Health Insurance Assistance Program (SHIP): 1-877-839-2675

Or for personal support: 👉 Meet Mary Lee — call, text, or schedule a free consultation.

📚 Sources and Citations

Information accurate as of October 2025 for coverage year 2026.

• Centers for Medicare & Medicaid Services (CMS) 2026 Fact Sheets & Final Rules
• Kaiser Family Foundation (KFF) Medicare 2026 Analysis
• Humana and PAN Foundation 2026 Policy Summaries
• CMS Medicare & You 2026 Handbook

🪶 Educational Disclaimer

This article and video are for educational purposes only and do not constitute a plan recommendation.
© 2025 Mary Lee Medicare Education 2026. All rights reserved.

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