Medicare Annual Election Period in Illinois

What to review before December 7 — plans, drugs, doctors, and the Part D out-of-pocket cap

Medicare Annual Election Period runs October 15 through December 7. That is the window most Illinois beneficiaries use to switch Medicare Advantage or Part D for a January 1 start.

This guide is educational. Plan directories, formularies, and extra benefits change every year. We compare what your doctors and medications actually need — we do not invent premiums or promise that last year’s “extras” survived the new Evidence of Coverage.

What AEP is for — and what it is not

During AEP you can typically:

Join, switch, or drop a Medicare Advantage plan
Join, switch, or drop a standalone Part D plan
Return to Original Medicare and add Part D, depending on the situation

AEP is not a general do-over for every Medicare decision. Medigap (a Medicare supplement) has a different guaranteed-issue calendar tied to Part B. After that window, medical underwriting can apply in Illinois. Do not wait until October 15 to buy a supplement you needed at 65.

If you recently moved, qualify for Extra Help, or have another special period, you may have options outside AEP. Most mid-year shopping still waits. Call before you drop a plan.

Part D and the annual out-of-pocket cap

The Inflation Reduction Act added an annual cap on out-of-pocket spending for Part D-covered drugs. CMS sets the dollar amount each year. We quote the current cap at the appointment rather than recycling a figure from a prior plan year.

The cap is not the whole story:

The drug has to be on the plan’s formulary
Tiers, prior authorization, and your pharmacy still matter
Advantage plans that include drugs use their own lists
Going without Part D (and without creditable coverage) can still mean a late-enrollment penalty that lasts

Bring the bottle list. A plan that looks cheap until a specialty drug is denied is not the plan.

What to bring to a Medicare review in Roselle

Medicare cards and any Advantage or Part D ID cards
Your doctors and the hospitals you actually use in the western suburbs
Every prescription, including dose and pharmacy
Last year’s Explanation of Benefits if you had a high-cost year
Whether you travel for months at a time (networks follow you poorly)
Employer or retiree coverage letters if you are still working or on a spouse’s plan

We map Part A (hospital), Part B (medical), Part C (Advantage), and Part D (drugs) as a set. Dental, vision, and hearing extras on some Advantage plans are limited — they are not a replacement for a dentist’s actual treatment plan. Separate dental, vision, and hearing policies still exist.

Illinois timing we still see people miss

October 15 is the start, not the homework date. Formularies and directories are out before AEP. Waiting until the first week of December is how a favorite specialist is out of network on January 1.

Late-enrollment penalties for Part B and Part D do not expire because you were busy. Employer coverage can delay the clock; COBRA and small-employer plans need a closer look.

AEP does not replace turning-65 counseling. Initial enrollment is a different calendar. If you are approaching 65, start with Medicare and the turning 65 case study — then use AEP in later years to repair a mismatch.

What we recommend before December 7

Check doctors and drugs first, premium second.
Confirm Part D or creditable coverage so a penalty is not an accident.
Treat Advantage extras as limited, not as a full dental or hearing policy.
Do not confuse AEP with a Medigap guaranteed-issue window.
Talk to an independent agent — we compare Medicare options from multiple carriers instead of a single company menu.

For plan terms, use the insurance glossary. To explore Parts A through D on the coverage page, visit Medicare.

Ready for an AEP review?

Request a quote or call 630-894-7510. Hausman-Kunkel Insurance has served Illinois from downtown Roselle since 1966.

Frequently Asked Questions

When is Medicare Annual Election Period?

AEP runs October 15 through December 7 every year. Most people can switch Medicare Advantage or Part D for a January 1 start. Missing it usually means waiting unless another enrollment period applies. We treat mid-October in Roselle as a deadline, not a suggestion.

Can I change Medigap during Annual Election Period?

AEP is built for Medicare Advantage and Part D. Medigap (supplement) has its own guaranteed-issue window around Part B. After that, Illinois underwriting can apply. Do not assume October 15 lets you swap supplement letters the way you swap Advantage plans.

Do I need Part D if I take few prescriptions?

Often yes, or you need creditable drug coverage from work. Going without Part D can trigger a late-enrollment penalty that does not expire. Even a modest formulary plan can be cheaper than the penalty plus a later diagnosis. We match your list during AEP.

What is the Part D out-of-pocket cap?

The Inflation Reduction Act created an annual cap on what you pay out of pocket for Part D-covered drugs. CMS sets the dollar amount for each year — we use the current figure at review time rather than a number from a prior brochure. Formulary, tiers, and your pharmacy still decide whether you reach that cap.

I am still working. Do I have to enroll during AEP?

Initial enrollment and delaying Part B because of creditable employer coverage follow different rules than AEP. Bring the employer’s Medicare letter. Enrolling late without a valid delay can mean penalties. We coordinate Medicare with the group plan instead of guessing.