There are usually only two specific times during the year when a person can change their Medicare plan. A Special Enrollment Period is available when qualifying events or other circumstances apply.

During a Special Enrollment Period (SEP), you can change your Medicare insurance. You may choose to join a plan for the first time, switch policies, or drop a policy.

You may be eligible for a Special Enrollment Period and not even know it.

Medicare Special Enrollment Periods Breakdown

A Special Enrollment Period allows you to switch your policy or sign up for Medicare outside of the regular Medicare enrollment periods.

Medicare Special Enrollment Periods

How Long Do Special Enrollment Periods Last?

The Special Enrollment Period for qualifying life events lasts for two months. But the Special Enrollment Period for working past 65 is 8 months.

What’s the Special Enrollment Period for Part B?

If you have coverage through your own or a spouse’s employer, the Medicare Part B SEP allows you to delay taking Part B without facing a penalty. When your employer coverage ends, you’ll have eight months to enroll in part B.

To be eligible for the Part B Special Enrollment Period you must have had credible employer group coverage when you first became eligible for Medicare or, you’re eligible for Medicare due to a disability.

If more than eight months passed since your employer group coverage was canceled, you’ll no longer be eligible for this Special Enrollment Period.

What is the Medicare Advantage “Trial Period” Special Enrollment Period?

If you enroll in a Medicare Advantage plan when you first sign up for Medicare, you have what is called a 12-month trial period. The part C trial period gives you the flexibility to change from Medicare Advantage to a Medigap using a SEP.

The reason this SEP is so important here is that it gives you a Guaranteed Issue right into a Medigap policy. Meaning that you won’t go through medical underwriting in your Medigap is guaranteed to be approved no matter your health issues.

The trial period also gives you the ability to switch back to Original Medicare.

Is there a SEP for Medicare Part D Plans?

During your 12-month trial right of a Medicare Advantage plan, if you choose to leave Part C, you’ll have the opportunity to enroll in a Part D plan.

Will I Qualify for a Special Election Period When Moving?

When you move to a new county or a new state, it’s possible your current plan won’t be available to you. Eligibility varies depending on your situation.

When moving you have two months to enroll in a new plan, either from the time you move or the time you notify Medicare of the move.

What if I Move and I have Medigap Insurance?

When you move to another state with Medigap you won’t have to change your coverage if the plan is available in your new place of residence. You’ll still want to notify Medicare and your supplement company that you moved so they can update their information.

Depending on where you move there may be a change in your premium even though your coverage stays the same since Medigap plans are standardized.

Now if you’re moving to Massachusetts, Minnesota, or Wisconsin, you’ll notice they have their own state-specific plans, instead of the traditional letter plans available everywhere else.

Never drop your current Medigap policy until your new policy receives approval. When moving and having Medigap insurance, comparing plans in your new area could still be beneficial because another top company may have more competitive premiums in your new area.

Is there a SEP for Incarceration?

You have two months from leaving prison to use your Medicare SEP to enroll in a plan.

Immediately upon release, you’ll want to be in contact with Medicare and get the ball rolling on your coverage, so you don’t miss out on this time of eligibility.

Can I Change Plans if I have the Chance to Get Other Coverage?

A good instance when changing plans for a better policy makes sense would be if you have a Medicare Advantage plan but, a five-star Medicare Advantage plan is available in your area.

If you decide to go back to work and employer coverage becomes available to you, you may decide to leave Medicare and enroll in your employer plan. However, in many cases, Medicare makes more sense.

How Do I Know if I Qualified for a SEP?

Those unsure about eligibility should talk to a licensed insurance agent. This is to better understand the options available in your area that you’re eligible for enrolling.

If you’re recently moved and haven’t notified Medicare or your Medicare plan about the move, you need to immediately. This is also so you can ask about specific dates of enrollment eligibility.

If you’re losing coverage or your coverage is changing, you may be eligible for a SEP. Those with Medicaid, extra help, or other assistance may have additional SEPs that allow more frequent plan changes.

Those with chronic health issues are able to enroll in a Medicare Advantage Special Needs Plan anytime during the year. Qualifying for this type of plan is a SEP on its own.

If you want to change your coverage, contact a Medicare expert to guide you. You may be eligible for a Medicare special circumstance.

FAQs

What happens if I miss the Special Election Period?

For the most part, if you miss the Special Enrollment Period then you can’t reap those benefits. Outside of the Part B SEP, most Special Enrollment Periods are only two months long. Paying attention to the dates and making plan changes quickly is important.

Will I qualify for a Special Enrollment Period When Losing Coverage?

Losing coverage will qualify you for a Special Enrollment Period. Whether you lose employer health coverage, credible prescription drug coverage, or your plan leaves your network a SEP will be available to you.

What happens with Part C or Part D if I move?

With Part C or Part D, if you move to a new state or region that is outside your plans service area you will be able to change your plan. You can decide if you want a switch back to Original Medicare or enroll in a similar plan.

You may even decide to enroll in a Medigap policy, especially if Medicare Advantage plans are not competitive in your new residence.

How to Enroll in a Medicare Plan During Your Special Enrollment Period

Enrolling in a Medicare plan during your Special Enrollment Period is easy and can be done by phone or online. To find out if you qualify, give us a call, and will help you through the trenches of Medicare. Call us now to compare options in your area over the phone or use our online compare rates tool.

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by Lindsay Malzone, Lindsay Malzone is the Medicare expert for Medigap.com. She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.