You can make changes to your Medicare Advantage (Part C) and Medicare drug coverage (Part D) when certain events happen in your life, like if you move or you lose other coverage. These chances to make changes are called Special Enrollment Periods (SEP). The types of changes you can make and the timing depend on your life event.
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How Do Special Enrollment Periods Work?
Navigating Medicare’s enrollment rules can feel like an endless maze, but understanding Special Enrollment Periods (SEPs) can help you stay on the right route. These windows let you sign up for or change Medicare coverage outside of standard enrollment periods—if you qualify. If you think you might be eligible, your first stop should be contacting Medicare to confirm your eligibility and learn about the applicable deadlines.
For example, if you’re still working and have health coverage through an employer with fewer than 20 employees, it’s crucial to sign up for Medicare Parts A and B as soon as you’re eligible. Missing this turn could mean penalties that follow you throughout your Medicare journey.
The same caution applies to Medicare Part D for prescription drugs. If you skip signing up when you first qualify and don’t have creditable drug coverage from another source, a SEP might help you enroll later. However, penalties might still apply—so tread carefully.
If you’re unsure how Medicare interacts with your employer-provided health insurance, don’t rely on guesswork. Confirm with Medicare to make sure you’re following the right map. Missing the correct enrollment window could leave you paying late enrollment penalties for as long as you have Medicare. In the journey through Medicare, planning ahead is your best compass!
If you sign up for Part A or Part B during a Special Enrollment Period because of an exceptional situation, you’ll have 2 months to join a Medicare Advantage Plan (with or without drug coverage) or a Medicare drug plan (Part D). Your coverage will start the first day of the month after the plan gets your request to join.
Special circumstance | Changes you can make | How long the SEP lasts |
You move and your new home is out of your plan’s service area. | You can switch to a different Medicare Advantage (Part C) plan or Part D plan, or return to Original Medicare. | 2 months: If you tell your plan before you move, the SEP begins the month before you move. If you tell your plan after you move, your SEP begins the month you tell your plan about the move. |
You move, and there are new plan options available at your new address. | You can switch to a different Part C or Part D plan. | 2 months: If you tell your plan before you move, the SEP begins the month before you move. If you tell your plan after you move, your SEP begins the month you tell your plan about the move. |
You’re moving back to the United States after living abroad. | You can join a Part C or Part D plan. | 2 months |
You move into or out of a skilled nursing facility, psychiatric facility, rehab hospital, or long-term care facility. | You can join a Part C or Part D plan, switch to a different Part C plan, return to Original Medicare, or drop your Part D plan. | Your SEP continues as long as you live at the facility or for 2 months after you move out. |
You’ve just been released from jail. | You can join a Part C or Part D plan. | 2 months |
You’re no longer eligible for Medicaid. | You can join a Part C or Part D plan, switch to a different Part C plan, return to Original Medicare, or drop your Part D plan. | 3 months |
You no longer have health insurance from an employer or a union at your employer. | You can join a Part C or Part D plan. | 2 months |
Your employment ends, or your employer-provided plan ends. | You can sign up for Medicare Part A or Part B. | 8 months |
You have a chance to get coverage from an employer or a union plan. | You can drop your Part C or Part D plan and join your employer’s plan. | Your SEP ends when your employer allows you to join the plan. |
You lose creditable coverage through no fault of your own. | You can join a Part C plan with Part D coverage or join a Part D plan. | Your SEP continues as long as you live at the facility or for two months after you move out. |
You no longer have a Medicare cost plan. | You can join a Part D plan. | 2 months |
You’re enrolling in a PACE program. | You can drop your Part C or Part D plan. | anytime |
You’re no longer in a PACE program. | You can join a Part C or Part D plan. | 2 months |
You’re enrolling in TRICARE, VA, or another prescription drug plan. | You can drop a Part C plan with drug coverage or drop your Part D plan. | anytime |
Medicare sanctions your plan due to a problem with your plan. | You can change to a different Part C plan. | SEP length is determined by Medicare on a case-by-case basis |
Medicare is ending your plan. | You can change to a different Part C plan. | 2 months before your old plan ends until 1 month after your old plan ends |
Medicare is not renewing your plan. | You can change to a different Part C plan. | Dec 8 through the end of Feb |
You’re now eligible for both Medicare and Medicaid. | You can join, switch, or drop your Part C plan. | The SEP occurs once during each of these periods: • Jan to Mar • Apr to Jun • Jul to Sep |
You now qualify for the Extra Help program. | You can join, switch, or drop your Medicare Part D plan. | The SEP occurs once during each of these periods: • Jan to Mar • Apr to Jun • Jul to Sep |
You’re enrolling in a State Pharmaceutical Assistance Plan (SPAP) or you lose coverage from an SPAP. | You can join a Medicare Part D plan or a Part C plan with Part D coverage. | once per year |
You dropped a Medigap policy when you joined a Part C plan. | You can drop Part C and return to Original Medicare. | 1 year after you joined the Part C plan |
You have a special needs plan (SNP) but you no longer have a qualifying special need. | You can change to a Part C or Part D plan. | 3 months after your specified grace period closes |
You joined the wrong plan because a federal employee made a mistake. | You can join a Part C or Part D plan, switch to a different Part C plan, or return to Original Medicare. | 2 months |
You weren’t told that your private drug plan wasn’t as good as Medicare or your private drug plan is ending. | You can join a Part C plan with drug coverage or join a Part D plan. | 2 months |
Medicare just gave a 5-star rating to a plan in your area. | You can change to the 5-star Part C plan. | one time between Dec 8 and Nov 30 |
The Takeaway: Navigating Life Changes and Medicare SEPs
Life has a way of surprising us—new jobs, relocations, and other big changes can seriously impact your healthcare coverage. To make sure you stay on the right track, Medicare offers Special Enrollment Periods (SEPs). These handy windows let you add, drop, or change your Medicare plans when life takes an unexpected turn, even outside the usual annual enrollment periods.
If you move to a new area, lose existing coverage, or suddenly qualify for a credible healthcare plan through an employer, special program, or union, a SEP could be your opportunity to make needed changes without penalties.
When something shifts in your world, don’t wait. Reach out to Medicare as soon as possible to understand your options and the timing involved. Deadlines for SEPs are critical—miss them, and you might face penalties. Stay proactive, informed, and in control of your healthcare journey.
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