A Medicare Special Enrollment Period (SEP) is the time when Medicare beneficiaries are allowed to make changes to their Medicare plan or even enroll in Medicare if they delayed their initial enrollment.
However, in order to use the Special Enrollment Period to your advantage, you must first qualify for it.
Qualifying Events
A qualifying life event is a huge life-changing situation – this can sometimes be planned or unexpected. Either way, experiencing a big change may allow you to drop or change your health plan outside of the Annual Enrollment Period: Qualifying life events for enrolling in the Special Enrollment Period include, but not limited to:
- Losing other health coverage
- Moving out of your plan’s service area
- Your spouse’s loses his/her employer’s health insurance, and this leaves you uninsured
- Death of someone who shares your health insurance plan
- Becoming a dependent or adding a dependent
- A change in citizenship
Generally, if you become eligible for a Special Enrollment Period, you only have up to sixty days that follow the qualifying event to sign up for a Medicare plan. During this process, you will be required to prove that you qualify to sign up for Medicare based on the particular life event.
Changes You Can Make During a Special Enrollment Period
Depending on the qualifying life event that made you qualify for the Special Enrollment Period, you may be able to:
- Enroll in Medicare for the first time after missing the Initial Enrollment Period
- Switch from an Original Medicare (Parts A and B) to Medicare Advantage (Medicare Part C) plan and vice versa.
- Switch to a Different Medicare Advantage plan.
- Drop, change, add your prescription drug coverage.
- Drop your Medicare plan and choose an employer-provided plan.
How Do Special Enrollment Periods Work?
Usually, if you enroll in Medicare or make changes during the Special Enrollment Period, you won’t have to pay late enrollment fees, but there are few exceptions. If you have health insurance coverage through your employer, but there are less than 20 employees, it is vital to enroll in Original Medicare when you first qualify, or you may be penalized.
If you are not sure how your employer’s health insurance program works with Medicare, you may want to contact Medicare or an experienced Medicare expert to ensure you enroll at the right time.
If you have more questions about the things that make the Special Enrollment Period special, contact Eldridge Agency today.
