Medicare Special Enrollment Period (SEP)
What is the Medicare Special Enrollment Period?
The Medicare Special Enrollment Period (SEP) occurs when specific events or life changes happen. It triggers the opportunity to change your Medicare Advantage and Medicare Part D Prescription Drug coverage.
If you qualify for a Special Enrollment Period, Medicare is unlikely to charge you a late enrollment penalty. Your new coverage will begin the following month on the first day.
What is a Qualified Special Enrollment Period Event?
The most common events for Medicare Advantage are:
- Move to a new address
- Retire and lose employer health insurance
- Return to the U.S. after living abroad
- Move in or out of a skilled nursing facility or long-term care hospital
- Released from jail
Other qualifying circumstances include:
- Lose creditable coverage through no fault of your own
- Changes to your Medicaid, MSP, or Extra Help eligibility status
- You want to disenroll from your first Medicare Advantage Plan
- Become eligible for a Special Needs Plan (SNP) or lose eligibility for your SNP
- Enroll in a five-star Medicare Advantage Plan or Part D plan
- Turn 65 and qualify for a new Part D Initial Enrollment Period
- Your Medicare Advantage or Part D plan was consistently low-performing or terminates a significant number of network providers
- You drop your Medicare Advantage Plan during the Medicare Advantage Open Enrollment Period
- Experience an "exceptional circumstance"
Did You Postpone Enrolling in Medicare?
Some people postpone enrolling in Medicare. Usually, Medicare charges a penalty for late enrollment. However, if you have a qualifying event, Medicare does not charge the penalty.
If you or your spouse continued working after 65 and received health insurance from your employer, you may qualify for a Special Enrollment Period. Medicare provides eight months to enroll after you lose your employer's health insurance.
For Medicare Advantage or Medicare Part D, Medicare requires enrollment within 2 months of losing employer health insurance.
Other Enrollment Periods
Medicare provides for several Enrollment periods throughout the year:
- Initial Enrollment Period – When you first turn 65
- Annual Enrollment Period – October 15-December 7
- Medicare Advantage Open Enrollment Period – January 1-March 31
- General Enrollment Period – January 1-March 31
Where Can I Get Help with a Medicare Enrollment?
AARDY is the nation's fastest Medicare insurance marketplace. You can compare Medicare supplements and Medicare Advantage plans to find the one that best fits your needs.