The Medicare Special Enrollment Period (SEP) is typically a two-month span where you can make adjustments to your coverage because of a special circumstance. You can make changes to your Medicare Advantage plan or Part D drug plan during a Special Enrollment Period.
For more information, or any questions answered, you can contact Cornerstone Senior Advisors for guidance.
Change of Address
One example of eligibility for a Medicare SEP is a change of address. If you have a new address that is not in your plan’s coverage area, then you must sign up for a new Medicare Advantage or Medicare Prescription Drug Plan. You also have the option to revert back to Original Medicare.
When can you change Medicare Advantage Plans or Medicare Prescription (Part D) Drug Plans? If you alert your Medicare Plan before you move, then you can switch anytime between the month before the month you move through the next two months after you move. If you wait until after your address changes, your time period to change plans starts the month you inform your plan of your move, plus two months after the move.
If you do not enroll in a new Medicare Advantage Plan with the Special Enrollment Period time frame, you will automatically be enrolled in Original Medicare, rather than a Medicare Advantage Plan.
If you move to a new address that is still within your current plan’s coverage area, but you now have access to new coverage as well, you also fall within the timeframe for the Medicare SEP. If you move back to the United States after living outside of the country, you have two complete months after the month you move back to the U.S. to enroll in a Medicare Advantage Program or a Medicare Prescription Drug Program.
Other Qualifications for Medicare SEPs
If you lose your current coverage, such as loss of eligibility for Medicaid, or leave your employer’s health plan, you have the option of enrolling in a Medicare Advantage Plan or Medicare Prescription Drug Plan. You may also qualify by losing creditable coverage.
If you were covered under a Medicare drug plan, but left the plan, or dropped coverage in a Program of All-Inclusive Care for the Elderly (PACE) Plan, then you could qualify for a Medicare SEP.
Special Enrollment Periods and Extra Help
There are a few different circumstances where an individual falls under a Special Enrollment Period when receiving Extra Help. If you are eligible for both Medicare and Medicaid, then you have the option to drop your Medicare Advantage Plan or your Medicare prescription drug coverage. This is only allowed January-March, April-June, and July-September. You cannot use the Special Enrollment Period in October-December.
If you receive Extra Help paying for Medicare drug coverage, you may join, switch, or drop your Medicare drug coverage during all Special Enrollment Period times listed above, excluding October-December.
Switching to a new Medicare Advantage Plan or Medicare prescription drug coverage, or even switching back to Original Medicare, during a SEP can become confusing. But with Cornerstone Senior Advisors, we’re to help guide you through this process and make it as easy as possible.