Medicare Special Enrollment Periods (SEP): What You Need to Know
Life doesn’t always stick to a schedule, so knowing your options can be crucial if everything doesn’t go according to plan. If you missed your Initial Enrollment Period or want to make changes outside the usual windows, you may qualify for a Special Enrollment Period (SEP). Here’s some information to know to take advantage of this important opportunity.
What Is a Medicare Special Enrollment Period?
A Special Enrollment Period allows you to sign up for Medicare or make changes to your existing coverage outside of the standard enrollment periods — without penalty — if you experience certain qualifying life events.
SEPs are available for:
- Original Medicare (Parts A and B)
- Medicare Advantage Plans (Part C)
- Medicare Prescription Drug Plans (Part D)
Common Qualifying Events for a Special Enrollment Period
You may qualify for a Medicare SEP if you experience:
1. Loss of Employer or Union Coverage
If you had coverage through your or your spouse’s employer and lose it, you can enroll in Medicare without penalty.
Need help transitioning? Visit our Medicare Enrollment Guide.
2. Moving to a New Area
If you move out of your current plan’s service area (for Medicare Advantage or Part D), you’re eligible for a SEP to enroll in a new plan.
3. Changes in Medicaid Status
If you gain, lose, or have a change in eligibility for Medicaid, you qualify for a SEP to review or change your Medicare coverage.
4. Plan Changes or Errors
If Medicare or your plan makes a significant error, or if your plan’s contract with Medicare changes, you may be granted a SEP to adjust your coverage.
5. Natural Disasters or Other Emergencies
FEMA-declared emergencies sometimes trigger Special Enrollment Periods for affected individuals.
6. Enroll in a Five Star Rated Plan
If there is a plan in your area that has been rated five stars by Medicare, you may have the opportunity to use an annual chance to change to that plan.
How Long Do Special Enrollment Periods Last?
The length of your SEP can vary based on the qualifying event, but generally:
- Most SEPs last two to three months from the date of the qualifying event.
- Some SEPs give you specific windows — such as 60 days after losing employer coverage — to enroll or make changes.
Important: If you miss your SEP window, you may have to wait for the next General Enrollment Period and face penalties.
Why Use a Special Enrollment Period?
Using a SEP may allow you to:
- Avoid late enrollment penalties
- Keep your healthcare coverage current
- Adjust your plan to better meet your changing health needs
Let Us Help You Navigate Special Enrollment Periods
Knowing your rights and deadlines can save you time, money, and stress.
Schedule a time with us for a free, no-obligation consultation about your Medicare options and Special Enrollment Period eligibility!