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Dear Toni:

I turned 65 in February and did not enroll in a Medicare Prescription Drug plan. I have been told that I must wait until October for Medicare’s enrollment time. I need help now because I have been prescribed an expensive brand-name prescription. I thought I could enroll at any time of the year, but the application for Part D was denied by Medicare. What can I do? Thanks, Toni.

— James from Atlanta, Ga.

Hello, James:

Medicare’s Open Enrollment Period (OEP)/Annual Enrollment Period (AEP) is for enrolling in or changing a stand-alone Medicare Part D Prescription Drug plan or a Medicare Part C Advantage plan.

This year’s Medicare OEP/AEP enrollment starts on Wednesday, Oct.15, and will end at midnight Sunday, Dec. 7 (Pearl Harbor Day). All plans will have January 1 as their start date.

This is the time when you can make changes to your Medicare Part D Prescription Drug plan or Medicare Part C Advantage plan, or you can initially enroll if you missed your enrollment time when you were first eligible, as you did, James, when you turned 65. Unfortunately, you will receive a Part D penalty for not enrolling at the right time.

Below are the changes that a Medicare beneficiary can make during Medicare’s Open Enrollment Period/Annual Enrollment Period:

—Enroll in a stand-alone Medicare Part D Prescription Drug Plan, if you are like James and never enrolled when your Medicare began.

—Enroll in a stand-alone Medicare Part D Prescription Drug Plan, which can automatically disenroll you from a Medicare Advantage plan (if you need to disenroll from a Medicare Part C Advantage plan and return to Original Medicare).

—Change from one Medicare Part D Prescription Drug Plan to a new Medicare Part D Prescription Drug Plan.

—Enroll in a Medicare Advantage Part C Plan with a prescription drug plan.

—Change from one Medicare Advantage Part C Plan (with or without a prescription drug plan) to a new Medicare Advantage Part C Plan.

—Enroll in a stand-alone Medicare Part D Prescription Drug Plan to return to Original Medicare and purchase a Medicare Supplement.

—Enroll in a Medicare Part D Prescription Drug Plan and return to Original Medicare only.

—Or return to Original Medicare with no Medicare Part D Prescription Drug plan. Don’t forget there is a penalty for not enrolling in a Medicare Part D Prescription Drug plan when first eligible.

For those who already have either a Medicare Advantage Part C plan with or without prescription drugs or a stand-alone Medicare Part D Prescription Drug plan, Medicare’s OEP/AEP is the time to make sure your stand-alone Part D prescription drug plan or Medicare Advantage plan still meets your needs, especially if you've had any changes to your health.

Confused about whether a new Medicare plan is right for you? Chapter 6 of Toni’s“Medicare Survival Guide Advanced” edition at www.tonisays.com details various situations during Medicare’s Annual Enrollment Period, such as “still working past 65” or “doctor not accepting my Medicare Advantage plan.” Now is the time to explore your OEP/AEP options.

Visit www.medicare.gov to view 2026 Medicare Part D and Medicare Advantage plans, with enrollment starting Oct. 15. The website has a tool for helping you narrow your search for new Medicare Advantage and prescription drug plans.

It is wise to verify every year that your prescription drugs are covered on your Part D Medicare Prescription Drug plan. Medicare Advantage or prescription drug plans can change their prescription drug formulary each year, and if your prescriptions are not covered for the next year, you may have to pay 100% of that prescription yourself if it is not covered on your Part D plan.

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Toni King is an author and columnist on Medicare, Social Security and long-term care issues. She has spent nearly 30 years as a top sales leader in the field. If you have a Medicare question, email info@tonisays.com or call 832-519-8664. Sign up for the Toni Says newsletter at www.tonisays.com to keep up to date on Medicare changes.

©2025 Toni King. Distributed by Tribune Content Agency, LLC.

Copyright 2025 Toni King, Distributed by Counterpoint Media