Medicare offers a Special Enrollment Period (SEP) for individuals who experience certain life changes. This allows them to change their health coverage outside of the yearly Open Enrollment Period. In this blog post, we will discuss what the Special Enrollment Period is and what life changes qualify you for it. We will also provide some tips on how to enroll in Medicare during the SEP.

CTA-The-Ultimate-Guide-to-Medicare-Terminology
CTA-The-Ultimate-Guide-to-Medicare-Terminology

What Qualifies for a Medicare Special Enrollment Period to Switch Plans?

 People who already have Medicare may qualify for a 2-month Special Enrollment Period with certain qualifying life events. This Special Enrollment Period lets you switch to a different Medicare Advantage or Part D prescription drug plan.

 You may qualify for a 2-month Medicare Special Enrollment Period in the following situations:

  • You move out of your plan’s service area.
  • Your plan closes, stops serving the area where you live, significantly reduces its provider network or your plan consistently receives low Medicare star ratings.
  • You want to enroll in a 5-star plan at any time or drop your first Medicare Advantage plan within 12 months of enrolling.
  • You move into or out of a qualified institutional facility, like a nursing home.
  • You are enrolled in or lose eligibility for a qualified State Pharmaceutical Assistance Program.
  • You have Medicare financial assistance such as Medicaid, a Medicare Savings Program, or Extra Help, or you gain or lose eligibility for any of these.
  • You enroll in or leave the Program of All-Inclusive Care for Elderly (PACE).
  • You gain or lose eligibility for a Special Needs Plan.

 Some situations not listed here may qualify for a Special Enrollment Period as well. If you have questions about your situation, call your State Health Insurance Assistance Program for help.

Can Weather Cause a Special Enrollment Period?

 In some cases, severe weather conditions can disrupt Medicare plans’ ability to provide services. If this happens, you may be able to switch to a different plan outside of the regular enrollment period.

You may qualify for a Special Enrollment Period if:

Your plan is unable to provide the majority of covered benefits because of a natural disaster or another emergency.

A state or local Proclamation of Emergency is in effect in your plan’s service area and the emergency affects your plan’s ability to provide services.

You were displaced from your home due to a natural disaster or another emergency, and you temporarily live outside of your plan’s service area.

If you’re affected by a weather emergency and think you may qualify for a Special Enrollment Period, call your plan or the Medicare Plan Finder helpline at 

How Long Do Special Enrollment Periods Last?

 Special Enrollment Periods usually last for 60 days. However, if you worked past 65 and are now considering retiring you have 8 months to secure a carrier for your coverage.

What Happens if I Make the Wrong Decision During my Special Enrollment Period?

 If you made a mistake when you selected your plan during the Special Enrollment Period, you can make another change. Client has until the last day of your SEP to switch plans.

You may also be able to disenroll from your Medicare Advantage Plan and return to Original Medicare if you’re unhappy with your current coverage. You have until the 

Medicare Advantage

How to Enroll in Medicare During a Special Enrollment Period?

The best way to enroll in Medicare during a Special Enrollment Period is by using the Medicare Plan Finder tool on medicare.gov. You can also call an agent here for us to help you navigate what is available. This is the best way for you to avoid making mistakes when it comes to these difficult decisions. So many of our current clients were relieved to know that we work with 35 of the top carriers in their state. The feedback we get is the panic that they feel going through these dramatic changes in their lives reduces substantially when they know we are always putting their needs first.

When the time comes that you lose coverage or have a change of life event. Please do not hesitate to reach out to us. We will be able to tell you how long your timeline is and help you to make the most knowledgeable decision you can with whatever your situation happens to be. Always do your research and never be afraid to ask questions. Give us a call if you have any questions!