Do You Qualify For A Special Enrollment Period? | Medicare Plan Finder

Do You Qualify For The Special Enrollment Period?

Anastasia Iliou Medicare

Special Enrollment Period Qualifications

Are you unhappy with your Medicare plan? Do you qualify for a Special Enrollment Period?

In most cases, you are not able to change your Medicare plan outside of your IEP (Initial Enrollment Period). Your IEP begins three months before you turn 65, continues throughout your birthday month, and ends three months after your birthday. If you already receive social security or railroad retirement benefits, your enrollment will happen automatically. Otherwise, you’ll need to enroll.

If you miss that period, you have another chance to apply during the GEP, or General Enrollment Period, from January 1st through March 31st, but you’ll need to pay a penalty fee for applying late. That’s why it’s important for you to apply during your Initial Enrollment Period!

Once you’ve enrolled, you are essentially stuck with your plan. Sometimes, though, extraordinary circumstances will require a change or an addition to your health care plan that will leave you eligible for SEP, or the Speical Enrollment Period. Those circumstances may include:

  • Moving outside of your coverage zone
  • Switching jobs or leaving a job
  • Medicaid eligibility changes
  • Extra Help eligibility changes
  • SNP (special needs plan) eligibility changes
  • Moving into our out of a skilled facility
  • Leaving imprisonment
  • Your plan stops working with Medicare

If any of the above events apply to you, you will have 60 days from the occurrence to alter your health care plan.

Medicaid is an exception – even if you do not relate to any of the above events, you can apply for Medicaid at any point throughout the calendar year.