Life Events and Changes

What if you have a life-changing event?

Life happens. To meet these changes, Medicare created special enrollment periods that are designed to accommodate those who experience certain qualifying events that impact their Medicare benefits.

What is a Special Enrollment Period?

A Special Enrollment Period (SEP) is a designated time frame during which eligible individuals can enroll in or make changes to their Medicare coverage due to a special circumstance.  

Some examples of special enrollment periods include:

If you are leaving an employer plan and enrolling in Medicare for the first time, you have eight months from the loss of your employer coverage.

If you are currently enrolled in Medicare and you experience a life changing event, you have two full months to change your Medicare benefits.

What qualifies for a Medicare SEP?

If you delayed your enrollment into Medicare because you continued on your employer plan past 65, you have an 8-month special enrollment period

During this special enrollment period, you can apply for Medicare Parts A (if you didn’t already), B, C and D, as well as a Medicare Supplement plan. 

Note: It is recommended that you apply for Medicare Parts A and B prior to your loss of employer coverage to avoid any gaps or delayed coverage.

Additionally, you only have 63 days from the loss of your employer coverage to enroll in a plan with creditable Part D prescription drug coverage. Should you miss this window, you’ll be faced with lifetime late enrollment penalties, as well as a delay in getting prescription drug coverage.

You will qualify for a two full months special enrollment period to change your benefits when you experience any of the following life events:

You move out of your Medicare plan’s service area

✓  You elect to enroll in a 5-Star plan

  You move in to, or move out of a nursing home/ long-term care hospital

  You gain/ lose Medicaid eligibility

  You gain/ lose eligibility for a special needs plan

  Your plan stops serving the area where you live

  Your plan received low Medicare star ratings

  Your Medicare plan is withdrawn from the Medicare program

  You exercise your Medicare Advantage Trial Right (up to 12 months from your initial enrollment in to Part C)

To avoid a late enrollment penalty, you must enroll in Part D prescription drug benefits within 63 days of losing employer coverage.

Do you need help with your Medicare when life happens?

Our licensed Medicare insurance agents can provide you with the timeline and required actions necessary to take to successfully address your Medicare benefits.

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