Navigating Medicare Special Enrollment Periods (SEPs)
Published: 03.14.2025
What is a Medicare Special Enrollment Period?
Medicare beneficiaries may qualify to make changes to their Medicare Advantage and Medicare drug coverage if certain life events occur, such as moving or losing other health coverage.These opportunities to adjust your plan are known as Special Enrollment Periods, also referred to as Medicare SEPs. The changes you can make and when you can make them depend on your specific life event.
Here are some of the most common Medicare Advantage and Medicare Part D Special Enrollment Periods.
Medicare Special Enrollment Period Chart
| Qualifying Event | What Can I Do | When |
|---|---|---|
| I moved to a new address that isn’t in my plans service area | Switch to a new Medicare Advantage or Medicare drug plan | If you tell your plan after you move, your chance to switch plans begins the month you tell your plan, plus 2 more full months. |
| I moved back to the U.S. after living outside the country | Join a Medicare Advantage or Medicare drug plan | Your chance to join lasts for 2 full months after the month you move back to the U.S. |
| I live in or recently moved out of a facility (like a nursing home or rehabilitation hospital) | Join a Medicare Advantage Plan or Medicare drug plan. Switch from your current plan to another Medicare Advantage Plan or Medicare drug plan. Drop your Medicare Advantage Plan and return to Original Medicare. Drop your Medicare prescription drug coverage. |
Your chance to join, switch, or drop coverage lasts as long as you live in the facility and for 2 full months after the month you move out of the facility. |
| I’m no longer eligible for Medicaid | Join a Medicare Advantage Plan or Medicare drug plan. Switch from your current plan to another Medicare Advantage Plan or Medicare drug plan. Drop your Medicare Advantage Plan and return to Original Medicare. Drop your Medicare prescription drug coverage. |
Your chance to change lasts for 3 full months from either the date you're no longer eligible or the date you're notified you're no longer eligible, whichever is later. |
| I have Medicare and get full Medicaid benefits | Join or switch to a plan that can help coordinate coverage between my Medicare and Medicaid managed care plans (called an integrated Dual Eligible Special Needs Plan (D-SNP)) if one’s available in my area | If you qualify for this Special Enrollment Period, you can join or switch to an integrated D-SNP once a calendar month. The change will take effect on the first day of the next month. |
| I left coverage from my employer or union (including COBRA coverage) | Join a Medicare Advantage or Medicare drug plan | Your chance to join lasts for 2 full months after the month your coverage ends. |
| I qualify for Extra Help paying for Medicare Prescription drug coverage | Switch to a different Medicare drug plan. Drop a Medicare Advantage Plan with drug coverage and return to Original Medicare by joining a stand-alone Medicare drug plan. |
If you get Extra Help, you can make changes to your coverage once a calendar month. The change will take effect on the first day of the next month. |
| I’m enrolled in a State Pharmaceutical Assistance Program (SPAP) | Join either a Medicare drug plan or a Medicare Advantage Plan with drug coverage. | Once during the calendar year. |
| I’m enrolled in a State Pharmaceutical Assistance Program (SPAP) and I lost SPAP eligibility | Join either a Medicare drug plan or a Medicare Advantage Plan with drug coverage. | Your chance to switch starts either the month you lose eligibility or the month you're notified of the loss, whichever is earlier. It ends 2 months after either the month of the loss of eligibility or notification of the loss, whichever is later. |
| I dropped a Medigap policy the first time I joined a Medicare Advantage Plan and I'm still in a "trial period" and eligible for guaranteed issue of a Medigap policy. | Drop your Medicare Advantage Plan and enroll in Original Medicare. You'll have special rights to buy a Medigap policy. | Your chance to drop your Medicare Advantage Plan lasts for 12 months after you join the Medicare Advantage Plan for the first time. |
Do you have questions about Medicare SEPs?
Our dedicated team of Medicare experts is ready to help you better understand Medicare SEPs and determine if you qualify to make changes to your current Medicare coverage.If you have questions on our Medicare SEP Chart above or would simply like to discuss your current coverage, reach out to our team today.
