You Might Qualify for a
Special Enrollment Period
Under what circumstances can you change plans outside of Medicare open enrollment?
Medicare open enrollment (October 15 to December 7) is when you can change your Medicare Advantage or prescription drug plan each year.* There are a few circumstances when you’re allowed to make changes outside that timeframe, called special enrollment periods.
Here are a few common examples of special enrollment periods.
Moving to a new address
If you move to a new address that isn’t in your plan’s service area, or you’re still in your plan’s service area but you have new plan choices, you can switch to a new Medicare Advantage or prescription drug plan. Your chance to switch begins the month before you move and continues for two full months after you move.
If you’re in a Medicare Advantage plan and you move outside your plan’s service area, you can also choose to return to Original Medicare. If you don’t enroll in a new Medicare Advantage plan during the allowed timeframe, you’ll be enrolled in Original Medicare when you’re disenrolled from your old plan.
If you’re moving back to the United States after living outside the country, you can join a Medicare Advantage or prescription drug plan within two full months after the month you move.
If you’re moving into or out of an institution such as a skilled nursing facility or long-term care, or you’re being released from jail, you may also qualify for a special enrollment period.
Losing your current coverage
If you lose your current coverage, you may qualify for a special enrollment period. Some examples include no longer being eligible for Medicaid, leaving coverage from your former employer or union, or losing other drug coverage that’s as good as Medicare drug coverage. Under these and several other circumstances, you can join a Medicare Advantage or prescription drug plan.
Gaining other coverage options
If you are offered other coverage through your employer or union or have a chance to enroll in other drug coverage as good as Medicare, you may be able to drop your current Medicare Advantage or prescription drug plan and enroll in the other coverage.
Changing Medicare contracts
If your plan notifies you that its Medicare contract has ended or is sanctioned, you can join a different Medicare Advantage or prescription drug plan. See the details and timelines for switching at medicare.gov.
Other special circumstances
This is a partial list of special enrollment periods. Other circumstances may qualify you to change plans outside the open enrollment period. To see all the details and the complete list of circumstances, visit medicare.gov.
If you have additional questions about special enrollment periods and whether you qualify, contact us to schedule an appointment with a licensed Benefits Advisor.
* Medicare Supplement plans can be changed any time during the year (medical underwriting may apply).
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