Medicare Special Election Periods

Medicare has specific enrollment periods when you can sign up. Each has a particular purpose. Most people sign up during their Initial Enrollment Period, but it’s good to know about all the time periods and what they’re for.

Initial Enrollment Period (IEP)

Annual Enrollment Period (AEP)

Medicare Special Election Period

AEP Is the time of year when Medicare beneficiaries can add and change their Medicare Advantage and Prescription Drug plans. The AEP begins on October 15th and ends on December 7th.

The Medicare plan that you enroll into will take effect for the beginning of the new year starting on January 1st. You will not be responsible for notifying your insurance carrier that you are dropping the plan, the enrollment submission during the AEP will automatically disenroll you from the current plan at the end of the year.

Special Election Period (SEP)

Medicare Special Election Period

A Special Enrollment Period (SEP) allows you to join, change or drop a Medicare Advantage (Part C) or prescription drug (Part D) plan outside of Medicare Annual Enrollment in certain situations. These situations are called “qualifying events.”

In general, you have 2 full months after the month of a qualifying event to make plan changes.

If you are moving, the timing of your SEP is based on when you notify your plan. If you notify your plan before you move, your SEP is based on the month that you actually move. If you notify your plan after you move, your SEP is based on the month that you notify your plan. In either case, your SEP lasts for 2 more full months.

Some common qualifying events for SEP include:

  1. You are moving outside your current Medicare plan’s service area
  2. You are moving within your current plan’s service area, but you have a new plan options
  3. You are moving into or out of an institution
  4. You are retiring from work and thus are disenrolling from your employer's health care plan.
  5. You are not retiring from work, but are disenrolling from your employer's health care plan.
  6. You are leaving retiree, union or COBRA coverage.
  7. You are losing creditable drug coverage.
  8. Your current Medicare plan stops servicing your area.
  9. You are on Medicaid (once per year) or are newly receiving Medicaid
  10. You were diagnosed with a chronic disease, such as pulmonary or cardiac, and require a Special Needs Plan (SNP).

Other life events may qualify for this SEP, too. You may want to call your local Essential Solutions Medicare Agent to discuss.