Outside the Annual Enrollment Period, you can only enroll in a plan after a special event with a Special Enrollment Period (SEP).
These are the different kinds of SEPs.
- Moved to a new service area or to an area with new plan options:
- You can switch to a new Medicare Advantage or Part D plan, or if you move outside your Medicare Advantage plan's service area, you can also return to Original Medicare.
- If you tell your plan before you move, your SEP begins the month before the month you move and goes for 2 full months after you move.
- If you tell your plan after you move, your SEP begins the month you tell your plan, plus 2 more full months.
- Moved back to the U.S. after living outside the country:
- You can join a Medicare Advantage or Part D plan.
- Your SEP lasts for 2 full months after the month you move back.
- Moved into an institution, like a skilled nursing facility or long-term care hospital:
- You can join or switch Medicare Advantage or Part D plans, drop your Medicare Advantage plan and return to Original Medicare, or drop your Part D plan.
- Your SEP lasts for as long as you live in the institution and for 2 full months after you leave the institution.
- Released from jail:
- You can join or switch Medicare Advantage or Part D plans, drop your Medicare Advantage plan and return to Original Medicare, or drop your Part D plan.
- Your SEP lasts for 2 full months after the month you're released.
- Eligible for both Medicare and Medicaid:
- You can join, switch, or drop a Medicare Advantage or Part D plan.
- You can do this at any time.
- No longer eligible for Medicaid:
- You can join a Medicare Advantage or Part D plan.
- Your SEP lasts for 2 full months after the month you find out you’re no longer eligible for Medicaid.
- Qualified for extra help paying for Medicare prescription drug coverage:
- You can join, switch, or drop a Medicare Advantage or Part D plan.
- You can do this at any time.
- Won't be eligible for extra help the following year:
- You can join or switch Medicare Advantage or Part D plans, drop your Medicare Advantage plan and return to Original Medicare, or drop your Part D plan.
- Your SEP is between January 1 and March 31.
- Have a chance to enroll in employer or union coverage:
- You can drop your current coverage to enroll in this private plan.
- Your SEP is whenever your employer or union allows you to make changes in your plan.
- Left employer or union coverage:
- You can join a Medicare Advantage or Part D plan.
- Your SEP lasts for 2 full months after the month your coverage ends.
- Have or are enrolling in other drug coverage as good as Medicare's, like TRICARE or VA coverage:
- You can join a Medicare Advantage or Part D plan.
- Your SEP lasts for 2 full months after the month your coverage ends.
- Lost creditable drug coverage through no fault of your own, or it changed and is no longer creditable:
- You can join a Medicare Advantage plan with drug coverage or a Part D plan.
- Your SEP lasts for 2 full months after the month you lose creditable coverage or are notified of the loss of creditable coverage, whichever is later.
- Weren't told that you were losing creditable coverage:
- You can join a Medicare Advantage plan with drug coverage or a Part D plan.
- Your SEP lasts for 2 full months after the month you get a notice from Medicare about the error.
- Weren't told that your private drug coverage wasn't creditable coverage:
- You can join a Medicare Advantage plan with drug coverage or a Part D plan.
- Your SEP lasts for 2 full months after the month you get a notice from Medicare about the error.
- Left your Medicare Cost Plan drug coverage:
- You can join a Part D plan.
- Your SEP lasts for 2 full months after the month you drop your Medicare Cost Plan.
- Enrolled in a PACE plan:
- You can drop your current Medicare Advantage plan with drug coverage or your Part D plan.
- You can do this at any time.
- Dropped your coverage in a PACE plan:
- You can join a Medicare Advantage or Part D plan.
- Your SEP lasts for 2 full months after the month you drop your PACE plan.
- Enrolled in a State Pharmaceutical Assistance Program (SPAP):
- You can join a Medicare Advantage plan with drug coverage or a Part D plan.
- You can do this once during the calendar year.
- Lost your SPAP eligibility:
- You can join a Medicare Advantage plan with drug coverage or a Part D plan.
- Your SEP starts either the month you lose eligibility or are notified of the loss, whichever is earlier, and ends 2 months after either the month of the loss of eligibility or notification of the loss, whichever is later.
- Dropped a Medicare Supplement plan the first time you joined a Medicare Advantage plan:
- You can drop your Medicare Advantage plan and enroll in Original Medicare with special rights to buy a Supplement plan.
- You can drop your Medicare Advantage plan for 12 months after you join it for the first time.
- Joined a Medicare Chronic Care SNP plan available for your condition:
- You can join a Medicare Chronic Care SNP for people with your condition.
- You can join any time, but you can't make changes using this SEP once you've joined.
- Live in the service area of Medicare Advantage or Part D plans with an overall quality rating of 5 stars:
- You can join a Medicare Advantage, Medicare Cost, or Part D plan with an overall quality rating of 5 stars.
- You can do this one time between December 8 and November 30.
- Medicare evaluates plans based on a 5-Star Rating System. Star Ratings are calculated each year and may change from one year to the next.
- Medicare took an official action, or sanction, because of a problem with your plan that affects you:
- You can switch from your Medicare Advantage or Part D plan to another plan.
- Your SEP is determined by Medicare on a case‐by‐case basis.
- Your plan's contract ends during the contract year:
- You can switch from your Medicare Advantage or Part D plan to another plan.
- Your SEP starts 2 months before and ends 1 full month after the contract ends.
- Your plan's contract isn't renewed for the next contract year:
- You can switch from your Medicare Advantage or Part D plan to another plan.
- You can do this between October 15 and the last day in February.
- Joined or didn't join a plan because of a federal employee's error:
- You can join or switch Medicare Advantage or Part D plans, drop your Medicare Advantage plan and return to Original Medicare, or drop your Part D plan.
- Your SEP lasts for 2 full months after the month you get a notice from Medicare about the error.
- Enrolled in Part B coverage during the General Enrollment Period without having Part A coverage:
- You can sign up a Part D plan.
- You can do this between April 1 and June 30.