6 Reasons You Might Be Eligible for a Medicare Special Enrollment Period

Special Election Period Blog
By James O'Neal

6 Reasons You Might Be Eligible for a Medicare Special Enrollment Period

Special Election Period: Most people know about the Medicare Annual Election Period each fall and the new Medicare Advantage Open Enrollment Period from January 1 through March 31. But you may have other opportunities to sign up for—or change—your Medicare coverage. Here’s what you need to know about some of the more common Medicare Special Enrollment Periods.

You lose your employer or union coverage

If you delay Medicare enrollment because you’re working past age 65, you have an opportunity to enroll in Medicare—and buy a Medigap plan, if you like—once you leave your job. You have an eight-month enrollment period if you choose Original Medicare, but if you want a Medicare Advantage plan or a Part D prescription drug plan, you have 63 days from the day your coverage ends. You also have a six-month Medigap Open Enrollment Period once you sign up for Part B.

You qualify for Medicaid or a Medicare Savings Program

Once you are notified you qualify for Medicaid—or lose your Medicaid benefits—you have three months from the date of notification to make changes in your Medicare coverage. You can switch between Medicare Advantage plans, return to Original Medicare, and switch between Part D prescription drug coverage during this three-month period.

You move into or out of long-term care

If you are admitted to long-term care, you can change your Medicare and Part D prescription drug coverage at any time during your stay. Once you are discharged from a nursing home, you have two months from your discharge date to make Medicare changes.

You have a permanent change of address

If you move out of your Medicare Advantage or Part D prescription drug plan’s coverage area, you have a special enrollment period to find a new plan. You need to notify your plan that you are moving; your special enrollment period begins the month you notify your plan and last for two additional months. During that time, you can enroll in a new Medicare Advantage plan or switch to Original Medicare.

You dropped your Medigap plan the first time you switched to Medicare Advantage

You have 12 months to drop Medicare Advantage and return to Original Medicare the first time to enroll in a Medicare Advantage plan. Once you re-enroll in Original Medicare, you’ll have a special enrollment period to buy Medigap with guaranteed issue rights.

You’re in a poor performing Medicare Advantage or Part D Prescription Drug Plan

All private Medicare plans are given star ratings each year. If your plan gets a rating of two stars or fewer, Medicare will send you a notice in October. Once you get that notice, you have until the end of the current year and the entire following year to switch to a new plan with a rating of three stars or more.

Medicare understands that life happens and circumstances change, so they make it possible for you to make changes to your Medicare coverage when you need to. But you have to act quickly or risk losing your special enrollment period. If you have questions about a life event and how it affects Medicare, get in touch with one of our licensed agents. We’re happy to walk you through your options and help you find the right plan for your situation. hot “Special Election Period”