Special Enrollment Periods are for people who have circumstances impacting the time they can enroll. If you are 65 and still have coverage through an employer, you may qualify for a Special Enrollment Period allowing you to enroll when your coverage or employment ends. For those who experience a move or loss of coverage, Special Enrollment Periods are also available.
Qualifying Circumstances
Special Enrollment Periods (SEP) are open only for specific and unavoidable circumstances. These circumstances can include:
- Moving out of your plan’s service area
- Losing your current plan’s coverage, or your coverage with Medicare has changed
- Applying for different coverage now, but applying for Medicare later when you no longer receive that coverage
If you are still working at 65 and receiving health coverage through your employer, you may qualify for a Special Enrollment Period, provided your employer has at least 20 employees. You will not receive a late penalty if you enroll for Medicare during this period. The enrollment period lasts for eight months and begins when you lose coverage or when you are no longer employed.
If you move and are no longer in your plan’s service area, you have two months from the move to enroll. If you tell your plan before the move, you have two months from the month you notify the plan to enroll in a new plan.
If you lose creditable drug coverage, you have two months to enroll in a Medicare Prescription Drug plan (Part D) or a Medicare Advantage plan with drug coverage.
If you enroll in a Program of All-inclusive Care for the Elderly (PACE) plan, you can drop your Medicare Advantage plan or Medicare Prescription Drug Plan at any time.
For those eligible for Medicare and Medicaid, you can make a change to your plan between January and March, April and June, and July and September. All Medicare beneficiaries can make changes between October 15 and December 7.
Those in Extra Help through Medicare can join, switch, or drop a Medicare Prescription Drug Plan from January to March, April to June, and July to September. One change can be made during those time periods, and one change can be made from October 15 to December 7.
If you have joined a Medicare Advantage policy after dropping a Medigap plan, you have special privileges to switch back to a Medigap plan within a year.
