Eligibility for Medicare: Special Enrollment Periods

Medicare Special Enrollment Period  (SEP)

There are exceptions to the rules that allow you to switch Medicare Advantage (Part C) or prescription drug (Part D) coverage without waiting until AEP. These exceptions are called “qualifying events.” If you qualify for any of them, you can join, leave or change your coverage during a Medicare Special Enrollment Period (SEP). 
 
 “Qualifying events” for Special Enrollment Period include:

• Moving out of your plan’s service area
• Moving within your current plan’s service area, with new plan options
• Moving into or out of a qualified institution (nursing home, psychiatric hospital, etc.)
• Leaving your employer, or the end of retiree, union or COBRA coverage
• Losing creditable drug coverage through no fault of your own
• Your current Medicare plan stops servicing your area
• Qualifying to enroll in a Medicare/Medicaid dual-eligibility Special Needs Plan
• Other life events may qualify for SEP, too. Call your local State Health Insurance Assistance Program (SHIP) office for details.

If you’re covered under an employer group health plan when you’re first eligible for Medicare, you have an eight-month Special Enrollment Period that starts the month after your employment ends or your employer group health plan ends, whichever happens first, to sign up for Medicare.