What Is The Special Enrollment Period

by | Oct 20, 2020

If you are planning to enroll in Medicare, but have missed your Initial Enrollment Period, you may be interested in finding out whether you qualify for a Special Enrollment Period. A Special Enrollment Period allows you to apply for Medicare benefits outside of a standard enrollment period. Here’s what you need to know about Medicare Special Enrollment Periods. 

What Is The Medicare Special Enrollment Period

If you are unable to enroll during a standard enrollment period, a Special Enrollment Period would allow you to enroll at a non-standard time. Oftentimes, Special Enrollment Periods also allow you to avoid the consequences of late enrollment, such as late enrollment penalties and lapses in coverage. In order to qualify for a Special Enrollment Period, you must meet specific criteria. 

Special Enrollment Period Requirements

If you want to make changes to your Medicare Advantage plan or switch from Medicare Advantage to Original Medicare, you can do so during a Special Enrollment Period. To qualify for this period, you must have met certain criteria. Some examples include the following:

  • You recently moved to an address that wasn’t in your plan’s service area
  • You moved to a new address in the same service area, but have new policy options in your area
  • You recently moved back to the U.S. after living outside of the country
  • You just moved into, currently live in, or just moved out of an institution, such as a skilled nursing facility
  • You were recently released from jail
  • You have a chance to get other coverage
  • Your plan changes its contract with Medicare

Other Situations That May Qualify You For SEP

You may qualify for a Special Enrollment Period if you are eligible for both Medicare and Medicaid. There are other special situations that may allow you to qualify for a Special Enrollment Period, they include:

  • You have a severe or disabling condition and there’s a Medicare Chronic Care Special Needs Plan serving people with your condition
  • You qualify for Extra Help paying for Medicare prescription drug coverage
  • You joined a plan chose not to join a plan, due to an error by a federal employee

These are only some of the situations that may qualify you for a Special Enrollment Period. For a more comprehensive list, visit the Medicare.gov site or get in touch with a Medicare specialist. 

Enroll During A Special Enrollment Period

Get help finding out if you are eligible for a Special Enrollment Period. The Medicare professionals at The Fussell Group Insurance Advisors can help you determine if you are eligible for a Special Enrollment Period and walk you through the application process. Contact us now for a quick Medicare consultation.