AEP is officially in the rearview mirror. Whether you switched plans or stayed exactly where you were, there’s always that nagging question: “Okay… what happens after AEP?”
January can be a smooth transition, or a mess, depending on how prepared you are. This guide walks you through what to expect, what’s normal, what’s fixable, and which deadlines matter next.
When New Coverage Starts (January 1) — And What to Expect
If you made a change during AEP, it becomes effective January 1. That includes:
- New Medicare Advantage plans
- New Part D drug plans
- Plan changes, network changes, or cost changes
- Updates to benefits, copays, and drug tiers
A little friction in early January is normal. Systems update, pharmacies adjust, and doctors sync new contracts.
What’s not normal? Surprise bills, doctors suddenly “not covered,” or medications priced way higher than expected. Those can be fixed.
ID Cards, Provider Records & Early-Year Claims
January is famous for people waiting for their new plan cards. Here’s what to know:
- Your new plan card usually arrives in December but sometimes shows up in early January.
- Your doctor’s office might not see your updated coverage right away—provider systems lag.
- Your first claim of the year might process incorrectly, only to be corrected later.
If a provider says your coverage isn’t active, don’t panic. It’s usually a timing hiccup, not a denial.
MA OEP (Jan 1–Mar 31): Your One-Time Do-Over Window
If you’re in a Medicare Advantage plan, the Medicare Advantage Open Enrollment Period (MA OEP) gives you a second chance.
What you can do from Jan 1–Mar 31:
- Switch to a different Medicare Advantage plan
- Drop Medicare Advantage and return to Original Medicare
- Add a standalone Part D plan if you return to Original Medicare
What you cannot do:
- Switch standalone Part D plans
- Make multiple changes—you get one move during MA OEP
If your January experience with a new plan feels off, this window is your safety net.
SEPs: Special Enrollment Periods for Major Life Changes
If you’re asking, “Can I make changes after AEP?”, the answer is: maybe—if you qualify for a Special Enrollment Period (SEP).
Common SEP triggers:
- Moving out of your plan’s service area
- Losing creditable employer or union coverage
- Your plan leaving Medicare
- Gaining or losing Medicaid or Extra Help
- Errors or misinformation during your enrollment process
Each SEP has specific rules and deadlines, so timing matters.
Medigap Changes After AEP: Underwriting Still Applies
AEP is not when you change Medigap (Supplement) coverage. If you want to switch Medigap plans after January 1:
- You’ll usually face underwriting.
- Approval is not guaranteed.
- Premiums may vary based on age and health.
This catches many people by surprise. Medigap operates by different rules—AEP doesn’t override them.
Fixing Mismatches: Doctors, Drugs & Authorizations
January is when people discover, “This isn’t exactly what I thought I signed up for.” Here’s what you can fix.
1. My doctor isn’t showing as in-network.
Call the office. Their records may not be updated yet even if the plan contract is valid.
2. My medication costs more than expected.
Sometimes switching pharmacies solves the problem instantly. Check:
- Whether your pharmacy is preferred
- Whether the dosage changed
- Whether a prior authorization is required
- Whether your plan lists a cheaper therapeutic alternative
3. I was told I need prior authorization.
This is common at the start of the year. Your doctor often just needs to submit updated paperwork.
Get Organized: EOBs, Portals & Contact Numbers
A little organization here prevents a lot of frustration later. January is the perfect time to get your Medicare “house” in order:
- Set up your plan’s online member portal
- Save your customer service number
- Update your provider with your new coverage
- Keep a folder for your EOBs and plan materials
- Update your medication list
Brickhouse Support in Q1
We don’t disappear after December 7. In fact, the first quarter is one of the busiest times of year for us because so many people need help:
- Fixing early-year billing issues
- Sorting out drug coverage surprises
- Clarifying network questions
- Understanding prior authorization rules
- Deciding whether to use MA OEP
- Getting clear on out-of-pocket costs
If something feels off, we’re here to help you get back on track.
FAQs: What Happens After AEP?
When does my new Medicare coverage actually start?
Any changes you made during AEP take effect January 1. That includes switching Medicare Advantage plans, changing drug plans, or adjusting coverage. If you stayed where you were, your existing plan’s new benefits and costs also start January 1.
What if my new ID card hasn’t arrived yet?
It’s common. Cards often arrive late December or even the first week of January. In the meantime, your plan can give you a temporary ID number or a digital card so you can fill prescriptions or see your doctor.
Can I switch my plan again after AEP?
If you’re in a Medicare Advantage plan, yes. From January 1 to March 31, the Medicare Advantage Open Enrollment Period (MA OEP) lets you make one change: switch MA plans or go back to Original Medicare. You cannot switch standalone Part D drug plans during this window.
What’s the difference between MA OEP and a Special Enrollment Period (SEP)?
MA OEP is available to all Medicare Advantage members once a year. A SEP is triggered by a specific life change—moving, losing other coverage, gaining or losing Medicaid/Extra Help, or your plan exiting Medicare. SEPs can give you extra flexibility beyond March 31.
Can I change my Medigap (Supplement) plan after AEP?
Usually, yes—but you’ll face medical underwriting unless you’re in a guaranteed-issue situation. That means you could be charged more or denied based on health conditions. AEP doesn’t change Medigap rules.
Is it normal for early-year claims to process incorrectly?
Unfortunately, yes. Plans adjust systems in January, and claims sometimes hit before updates are complete. Most incorrect bills or denials get fixed on reprocessing—just save everything and follow up.
What if I realize I chose the wrong plan?
If it’s a Medicare Advantage plan, MA OEP gives you a one-time do-over. If it’s a Part D drug plan, you may need a SEP or may have to wait until next AEP—depending on the situation. In many cases, issues can be fixed without switching plans.
How can Brickhouse help after AEP?
We help update providers, troubleshoot drug pricing, sort out authorizations, walk you through MA OEP options, and clarify what your plan actually covers. Q1 is when most questions pop up—and when expert help makes the biggest difference.
