Many people know there are specific times of the year when they can make changes to Medicare coverage. Certain changes in your life, however, can give you another opportunity to join or change Medicare Advantage or prescription drug coverage. This opportunity is called a Special Enrollment Period, or SEP.
What Is a Medicare Special Enrollment Period?
A Special Enrollment Period allows you to make certain Medicare coverage changes outside the usual enrollment periods when you experience a qualifying event. Exactly what you can change, and how long you have to make the change, depends on your situation.
Moving to a New Address
Moving can affect your Medicare Advantage plan or prescription drug coverage, particularly when you move outside your current plan’s service area. Depending on your circumstances, you may have an opportunity to switch plans.
Losing Employer or Union Coverage
If you are leaving employer or union health coverage, you may also have a Special Enrollment Period for Medicare coverage. Timing matters, so it is important to understand your Medicare enrollment options before existing coverage ends whenever possible.
Losing Creditable Prescription Drug Coverage
If you involuntarily lose prescription drug coverage that is considered creditable, you may qualify for an opportunity to join Medicare prescription drug coverage. This can also apply if your existing drug coverage changes and is no longer considered creditable.
Other Situations May Qualify
Special Enrollment Periods may also apply in situations involving Medicaid, Extra Help, certain institutional care, changes involving Medicare plans, and other exceptional circumstances. The rules and time limits are not identical for every situation.
Do Not Assume You Have to Wait
Special Enrollment Periods are only one part of the Medicare enrollment process. Understanding Medicare enrollment periods and Medicare eligibility rules can help you know when you may be allowed to enroll or make changes.
Get Help Understanding Your Enrollment Options
Simple Medicare Choices can help explain Medicare plan options, Medicare Advantage plans, Medicare Part D, and enrollment rules in plain language.
