LearningCenter

Individuals have an initial enrollment period available to them to first enroll in Medicare. However, Medicare also allows those in certain circumstances to enroll in Medicare Part B at a later point. 

In addition, Medicare also offers special enrollment periods to those already enrolled in Medicare. Each year, Medicare beneficiaries have a chance to change their Medicare plan choices during the [annual enrollment](https://medicare.healthinsurance.com/learning-center/article/guide-to-medicare-annual-enrollment-period) period (AEP). Those with [Medicare Advantage](https://medicare.healthinsurance.com/learning-center/article/medicare-advantage-guide) can also change their Medicare Advantage plan, or return to [Original Medicare](https://medicare.healthinsurance.com/learning-center/article/how-to-fill-the-gaps-of-original-medicare-coverage), during the Medicare Advantage open enrollment period (MA OEP).

But what if you need to make a change to your Medicare plan outside of those dates? The government allows special enrollment periods (SEPs) for specific types of events where you will need immediate coverage before the next annual enrollment.

This guide will help you understand what SEPs are available and how each one works.


##Medicare SEP FAQ

It can be very challenging to keep up with which life events qualify for an SEP, especially if you’re in the middle of a move, job change, or other stressful situation. Plus, each SEP has its own rules. That’s why it’s important to know how each one works ahead of time, if possible.

###Medicare Special Enrollment Periods for Premium-Free Medicare Part A

Generally, you sign up for [Medicare Part A](https://medicare.healthinsurance.com/learning-center/article/medicare-part-a) automatically when you turn 65.

Not everyone retires at or before age 65. If you’re still working after age 65 and are covered under a group health plan, you don’t have to sign up for Medicare right away. 

Once you retire and stop working, you have an eight-month special enrollment period to sign up for premium-free Medicare Part A, along with a drug plan (Part D) or Medicare Advantage (Part C) if you prefer.

If you qualify for premium-free Medicare Part A, . you can sign up for it anytime because you don’t pay a premium, although you may have a gap in coverage. 

However, if you have to pay a premium for Medicare Part A, you can only sign up during approved enrollment periods or if a special enrollment period is triggered. 

###Special Enrollment Period for Medicare Part B

[Medicare Part B](https://medicare.healthinsurance.com/learning-center/article/understanding-medicare-part-b) carries a monthly premium, and if you sign up after your initial enrollment period you usually will face a penalty. There are exceptions, though, and many of them apply to events that cause a special enrollment period.

If you’re still working after age 65 and are covered under a group health plan, you may choose to delay signing up for Part B. Once you retire and stop working, you have an eight-month special enrollment period to sign up for Medicare Part B, along with a drug plan (Part D) or Medicare Advantage (Part C) if you prefer.

You get a special enrollment period for Part B if

- You have group health plan coverage
- You or your spouse (or a family member if you’re disabled) is working for the employer that provides your health coverage
- Generally, this SEP lasts for eight months from the above events.

###Special Enrollment Period for Medicare Advantage and Part D Plans

When you have a Medicare Advantage (MA)plan or a Prescription Drug Plan (also known as Medicare Part D), you can make changes during the normal annual enrollment period. However, there are times when you need to make immediate changes, and a special enrollment period can let you do that.

You can get a special enrollment period for an MA or Part D plan if:

- You lose group or union health coverage; this SEP lasts for two (2) months after that coverage ends.You move out of your plan's area, or to an area with new plan offerings; this SEP generally lasts from one month before your move until two months afterward
- You move back to the U.S. from abroad; this SEP lasts for two months after you return to the U.S.
- You move into or out of an institution; this SEP lasts as long as you live in the institution and for two full months afterward
- You are no longer eligible for Medicaid; this SEP lasts for three months from the date you’re notified or no longer eligible, whichever is later
- You are no longer eligible for a Special Needs Plan (SNP); this SEP lasts for three months after your disenrollment from the SNP
- You’re released from jail; this SEP lasts for two full months after you’re released
- If your MA or drug plan decides not to renew its contract for the next year, this SEP starts December 8th and ends on the last day in February of the following year
- You qualify for extra help with drug coverage - you qualify for an SEP every three months for the first 9 months of the year  

This is not an exhaustive list. If you have questions about Medicare enrollment or want to review your plan options, contact us today!

###Medicare Special Enrollment Period for a Disaster

If there is a Federal, State or locally declared emergency or disaster, the Center for Medicare Services (CMS) will designate a special enrollment period for those who missed their chance to enroll due to that event. 

The special enrollment period starts the date the declaration was made and continues for two full months following the end of the declaration.  This SEP also applies to those who don’t live in the affected area but rely on people in that area for help with healthcare decisions.


### Learn More About Medicare Special Enrollment Period (SEP)

There are a lot of life events that can impact your need for Medicare, and sometimes they happen outside of the normal enrollment timeframes. Special enrollment periods exist to help you get the coverage you need at the right time.

If you have questions about Medicare enrollment or want to review your [Medicare Advantage plan](https://medicare.healthinsurance.com) options, contact us today!


Understanding the Medicare special enrollment period is critical to know when and why you can make changes to your plan. We answer all your SEP questions in this guide.