Do I Qualify For A Special Enrollment Period?

You may qualify for a Special Enrollment Period if you have recently changed location or lost coverage if new coverage has become available, or for a number of other reasons. Refer to the Medicare website or speak with your local Social Security office to determine if you meet the criteria.

Change in Location

A change in where you live can trigger an opportunity to change coverage with Medicare. Such is the case if one of the following situations applies to you:

• You move to a new address outside of your current plan’s service area
• You move to a new address that is still within your current plan’s service area, but you now have additional plan options
• You move back to the United States from another country
• You moved into, live in, or moved out of an institution
• You were released from jail

Losing Coverage

When you lose coverage, you will need to apply for new coverage. One of these might apply to you:

• You are no longer eligible for Medicaid
• You left coverage from your employer or union
• You lose other creditable drug coverage, or your drug coverage is no longer creditable
• You had prescription drug coverage through a Medicare Cost Plan but left the plan
• You dropped coverage in a Program for All-Inclusive Care for the Elderly (PACE) plan

New Coverage Opportunities

Sometimes you get the opportunity to sign up for coverage when additional plans become available. This might be you if one of the following fits your situation:

• You have the chance to enroll in other coverage offered by your employer or union
• You have or are enrolling in other creditable drug coverage;
• You enrolled in a Program for All-Inclusive Care for the Elderly (PACE) plan

Change in Medicare Contract

Plans do not always keep their contract with Medicare. You may find yourself able to sign up for new coverage if one of the following occurs:

• Medicare sanctions your plan because of a problem that affects you
• Medicare terminates your plan’s contract
• Your Medicare Advantage, Medicare Part D, or Medicare Cost Plan’s contract with Medicare is not renewed

Other Situations

You may find yourself eligible to sign up for new Medicare coverage for a number of reasons. Here are some other reasons that could make you eligible for change:

• You are eligible for both Medicare and Medicaid
• You qualify for Extra Help for prescription drug coverage
• You are enrolled in a State Pharmaceutical Assistance Program (SPAP) or lose SPAP eligibility
• You dropped a Medicare Supplement plan the first time you signed up for Medicare Advantage
• You have a severe disabling condition and there is a Chronic Condition Special Needs Plan that serves your condition
• You joined or chose not to join a plan due to an error by a federal employee
• You were not properly told that your drug coverage was not creditable
• You were not properly told that you were losing creditable drug coverage

How to Use a Special Enrollment Period

Special Enrollment Periods give you a set period of time to sign up for Medicare coverage. When you have a Special Enrollment Period, you will likely not be charged late enrollment penalties for delaying signing up for Medicare.