What is a Medicare Special Enrollment Period (SEP)?
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SelectQuote can help you understand if you qualify for a Medicare Special Enrollment Period.
You can make changes to your existing Medicare Advantage and Medicare Prescription Drug coverage when certain events and life changes occur. For example, moving or losing employer coverage, may allow you to enroll in Medicare or make changes to your existing Medicare Advantage coverage. These changes are called Medicare Special Enrollment Periods (SEP). There are special rules about the changes that someone may be able to make during this time. Usually, you don’t pay a late enrollment penalty if you meet the requirements for a Special Enrollment Period. New Medicare coverage will begin on the first day of the following month. So if you qualified for a SEP in February for example, your coverage would begin in March.
There are several different types of Medicare Special Enrollment Periods with different qualification standards for each.
Some of the most common Special Enrollment Period events for Medicare Advantage include:
- Moving to a new address that isn’t in your current Medicare plan’s service area
- Moving to a new location where new Medicare plan options are available, even though your current Medicare plan also includes coverage for your new address
- Returning to the U.S. after living outside the country
- Moving in or out of a skilled nursing facility or long-term care hospital
- Being released from jail
There is also one Special Enrollment Period for Original Medicare (Parts A and B):
- Delaying enrollment in Medicare Parts A and B because you or your spouse worked after you turned 65 and you are losing your group coverage, or you (or your spouse) stopped working.
During this SEP, you may:
- Enroll in Part B (and Part A if you haven’t already). Beginning the month that follows the end of your employer coverage, you will be given a Special Enrollment Period of 8 months to sign up for Medicare Parts A and/or Part B.
- Enroll in Medicare Advantage (Part C) or a Prescription Drug Plan (Part D). You have 2 months to enroll in these options.
In addition, there is a Medicare Advantage SEP that is provided for individuals who are Dual-Eligible or receive “Extra Help” (also known as Low Income Subsidy). Extra Help is a federal program that helps pay for some to most of the out-of-pocket costs of Medicare prescription drug coverage. If you receive Extra Help in 2019, there is a SEP to enroll in a Medicare Advantage plan with or without drug coverage, or a Part D plan or switch between plans. This SEP is available once per quarter for the first three quarters of the year (January-March, April-June and July-September). Coverage changes become effective the first day of the month following the change.
For information on the other types of Medicare Enrollment Periods, click on the links below:
- Medicare Initial Enrollment Period
- Medicare Annual Enrollment Period
- Medicare Advantage Open Enrollment Period
SelectQuote is here to help you understand Medicare Special Enrollment Periods and the available Medicare plans in your area. We will independently shop up to 21 insurance companies so you can compare rates.
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