Enrolling outside of Open Enrollment or the Annual Election Period
You can make changes to your Medicare Advantage and Medicare prescription drug coverage when certain events happen in your life, such as a move or a loss of other insurance coverage. These chances to make changes are called Special Election Periods(SEPs). Rules about when you can make changes and the type of changes you can make are different for each SEP.
If you qualify for a Special Needs Plan (SNP), you can enroll in Medicare Advantage or Medicare prescription drug coverage year-round. People who are already enrolled with a Special Needs Plan may switch plans once per quarter from January 1 through September 30.
SNPs are available for those who are in a Medicare savings plan, or are receiving help from the state.
When does Special Election Period (SEP) coverage become effective?
- If you enroll in Medicare Part B while covered by a group health plan or during the first full month after coverage ends, your Medicare Part B coverage starts on the first day of the month you enroll. You also can delay the start date for Medicare Part B coverage until the first day of any of the following three months.
- If you enroll during any of the seven remaining months of the SEP, your Medicare Part B coverage begins the month after you enroll.
Who can qualify for a Special Election Period (SEP)?
For a variety of reasons, you may qualify to enroll in Medicare coverage at any time of the year. Below are situations that might qualify you for an SEP:
- You recently moved outside of the service area for your current plan.
- You recently had a change in your Medicaid (newly got Medicaid, had a change in level of Medicaid assistance, or lost Medicaid).
- You recently had a change in your Extra Help paying for Medicare prescription drug coverage (newly got Extra Help, had a change in the level of Extra Help, or lost Extra Help).
- You have both Medicare and Medicaid (or the state helps pay for your Medicare premiums) or you get Extra Help paying for your Medicare prescription drug coverage but haven’t had a change.
- You are moving into, live in, or recently moved out of a Long-Term Care Facility (for example, a nursing home).
- You recently left a PACE (Programs of All-Inclusive Care for the Elderly) program.
- You recently involuntarily lost your creditable prescription drug coverage (coverage as good as Medicare’s).
- You are leaving employer or union coverage.
- You belong to a pharmacy assistance program provided by the state.
- You recently returned to the United States after living permanently outside of the U.S.
- Your plan is ending its contract with Medicare, or Medicare is ending its contract with your plan.
- You were enrolled in a plan by Medicare (or your state) and you want to choose a different plan.
- You were enrolled in a Special Needs Plan (SNP), but you have lost the special needs qualification required to be in that plan.
Visit the SEP section on Medicare.gov to learn more about the circumstances that qualify you for an SEP.