Special Enrollment Periods for Medicare

Signing up for Medicare or changing your Medicare plan is possible at various times. If you are eligible for Medicare, it’s important to start considering your needs and goals as soon as possible. That includes learning more about Medicare special enrollment periods (SEPs).

During a Medicare SEP, you can make changes to your Medicare prescription drug coverage and Medicare Advantage plans. These are special enrollment periods, meaning you cannot make changes just at any time.

 

What Can You Do During Special Enrollment Periods?

Medicare special enrollment periods allow you to make changes to your coverage. This may include:

apply for medicare senior man on tablet

When Are SEPs?

In certain scenarios, you may be issued a Special Enrollment Period, during which you can make changes to your coverage. These scenarios include:

 

Change of Residence

Moving to an area where your current plan may not provide effective coverage may warrant making changes to your plan. For example, your new address may no longer be in your plan’s service area, or there may be new plan options that you did not have before.

You can also join, switch, or drop coverage while living in an institution (like a skilled nursing facility or long-term care hospital). Moreover, you can make coverage changes for two months after the month you leave the institution. Lastly, you may apply if you just moved back to the U.S. after living outside of the country or being released from jail.

You Lose Your Current Coverage

You may have lost coverage from your employer or union, such as COBRA coverage. If you’ve lost your drug coverage for various reasons, you may be eligible for an SEP, so you can put in place the proper plan, in some cases.

You Qualify for Coverage From Somewhere Else

You may be able to obtain an SEP if you have a chance to get coverage from somewhere else. For example, you may be able to enroll in insurance from a new employer or union. You may become eligible for other prescription drug coverage that is just as good as what you are receiving from Medicare. You may qualify for coverage through the U.S. Department of Veterans Affairs or the PACE program.

Your Plan Changes Its Contract

If your Medicare Advantage plan changes its contract with Medicare and that alters or otherwise impacts your coverage, you may be able to get into an SEP to make changes.

 

Review the full list of special circumstances that may qualify you to switch plans with Medicare.

It’s important to know your rights. If you believe you have an instance in which you need to make changes to your plan, it’s best to reach out to your provider to learn about your options or talk to the licensed agents at Senior Healthcare Direct for additional support and guidance.

Common questions about medicare

When you enroll in Medicare you sign up for Part A. However, Medicare Parts B, C, and D are optional so you can delay enrollment without penalty if you have credible coverage.

You can apply for Medicare Part B by filling out an online application at SSA.org, calling Social Security at 1-800-772-1213 or visiting your local Social Security office.

You must first be enrolled in either Medicare Part A or Medicare Part B. Then you can apply for Medicare Part D by calling Senior Healthcare Direct at 1-855-368-4717.

You do not have to apply for Medicare Part B. You can have only Medicare Part A. However, when you decide to get Medicare Part B, you may have to pay a late enrollment penalty.

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