Medicare offers Special Enrollment PeriodS (SEP)
Important Notice: If you have a Medicare Supplement Plan, also know as a Medigap policy. You do NOT need a Special Enrollment Period to switch plans. You can do it all year long AS LONG as you can pass the medical underwriting process.
Special Enrollment Periods for Advantage & Part D Drug Plans
You are limited in when and how often you can join, change or leave a Medicare Advantage Plan or prescription drug plan (Part D).
- You can enroll in a Advantage or Part D plan during the Initial Period when you first qualify for Medicare.
- You can switch from your Advantage Plan to another MA Plan, or to Original Medicare with or without a Part D plan, during the Medicare Advantage Open Enrollment Period (MA-OEP). The MA-OEP occurs each year from January 1 through March 31.
- You can change your health coverage and add, drop, or change your drug coverage during the Annual Enrollment Period. AEP occurs each year from October 15 through December 7.
Outside of the above periods, you can only change your health and/or drug coverage if you qualify for a Special Enrollment Period (SEP).
when a Special Enrollment Period may apply to you
1. You have creditable drug coverage or lose creditable coverage through no fault of your own
2. You choose to change employer/union coverage
3. You are institutionalized
4. You are enrolled in a State Pharmaceutical Assistance Program (SPAP)
5. You have Extra Help, Medicaid, or a Medicare Savings Program (MSP)
6. You gain, lose, or have a change in your Medicaid, MSP, or Extra Help
7. You want to disenroll from your first Medicare Advantage Plan
8. You enroll in/disenroll from PACE (Program of All-Inclusive Care for the Elderly)
9. You move (permanently change your home address)
10. You have had Medicare eligibility issues
11. You are eligible for a Special Needs Plan (SNP) or lose eligibility for it
12. You are passively enrolled into a Part D plan or Dual-eligible SNP (D-SNP)
13. You experience contract violations or enrollment errors
14. Your plan no longer offers coverage
15. You disenroll from your Advantage Plan during the MA-OEP
16. You qualify for a new Part D Initial Enrollment Period when you turn 65
17. You want to enroll in a five-star Medicare Advantage Plan or Part D plan
18. You have been in a consistently low-performing Advantage or Part D plan
19. Your Advantage Plan terminates a significant amount of its network
20. You experience an “exceptional circumstance
NOTE IF YOU HAVE MEDICAID: This SEP allows people who are dually entitled to Medicare and Medicaid to enroll, disenroll, or switch to another Advantage plan once per quarter during the first three quarters of the year, with the new election becoming effective on the first day of the next month.
If you believe that you might qualify for an SEP Period, use the appointment form below to scheduled a time to find out if we can find you a plan that offers more or better benefits.
For general questions please send us a message...
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