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When are Medicare Special Enrollment Periods?

When are Medicare Special Enrollment Periods?

Understanding Medicare enrollment periods is vital because enrolling late can leave individuals with huge penalties and fees. Many people know about the Medicare Annual Enrollment Period (AEP) from October 15 to December 7 every year, when individuals can change Medicare plans for the following year.

But what about Special Enrollment Periods? When are those?

Special Enrollment Periods (SEP) don’t have a set window like AEP does. Instead, they revolve around certain circumstances. There are many special circumstances that may qualify someone for a Special Enrollment Period.

  • Moving to a new location
  • Losing current coverage
  • A chance to get other coverage, such as from your employer
  • The plan in which a person is enrolled changes its contract with Medicare
  • Qualifying for Extra Help when paying for Medicare Prescription Drug coverage
  • A Five-Star Special Enrollment Period Exemption
  • Being eligible for both Medicare and Medicaid
  • Having a severe or disabling condition which makes you eligible for the Medicare Chronic Care Special Needs Plan
  • Having a Special Needs Plan (SNP) and no longer having the condition that qualifies as a special need

To read a list with more examples, click here.

Many of these special circumstances have a two or three month SEP. Special circumstances in which an individual will be dropping Medicare coverage—such as joining an employer health plan—can often be completed any time.

Here are some examples of how a Special Enrollment Period might apply.

Moving

Let’s say you move from Minnesota to Florida in August. After you get settled in your new (warm!) house in Florida, you call your health plan and tell them about the move. You then have all of August, plus two more months (September and October), to enroll in a new plan in your area.

Eligible for both Medicare and Medicaid

If you are eligible for both Medicare and Medicaid, you can join, change, or drop plans any time.

To see Medicare.gov’s official policy for Special Enrollment Periods for each circumstance, click here.

Don’t delay!

Two or three months can go quickly when you’re in the midst of major life changes. Making an important decision like choosing health insurance should not be placed on the back burner. We recommend evaluating choices and making a decision as soon as possible. Remember, there are penalties for enrolling late or having gaps in coverage!

Have questions or need to join, change, or drop plans? We’re here to make it easy. Call our licensed agents at 1-800-991-4407 / TTY 711 Monday-Friday from 10am to 6pm ET.