Who can qualify for a Special Election Period (SEP)?

For a variety of reasons, you may be able to sign up for or change Medicare coverage at any time of the year. This is known as a Special Election Period (SEP). Below are situations that might qualify you for an SEP:

• You move permanently outside your plan’s service area.
• You’re enrolled in another prescription drug plan or a Medicare Advantage Plan whose contract is ended.
• You are eligible for both Medicare and Medicaid (you are "dual eligible").
• You either recently qualified or no longer qualify for extra help paying for prescription drugs.
• You belong to a pharmacy assistance program provided by the state.
• You want to move from an employer-sponsored Prescription Drug Plan to a Medicare Prescription Drug Plan.
• Your enrollment or disenrollment is caused by an error by a federal employee or contractor hired by the federal government.
• You lose your previous coverage through no action of your own.
• You are approved for Medicare on a date after your Initial Election Coverage Period (ICEP).
• You want to leave your current Medicare Prescription Drug Plan because it was:
• Warned by the federal government; or
• The federal government has determined the plan broke its Medicare contract in relation to services provided to you.
• You’re enrolled in a plan that isn’t renewing its contract with Medicare. This SEP will last from October 1-December 31 of that year.
• You want to move from a Program of All-Inclusive Care for the Elderly (PACE) to an MA-PD.
• You live in — or are moving in or out of — one of the following:
• Skilled nursing facility
• Nursing facility
• Intermediate care facility for the mentally retarded
• Psychiatric hospital or unit
• Rehabilitation hospital or unit
• Long-term care hospital
• Swing-bed hospital
• You are not eligible for premium-free Part A and enroll in Medicare Part B during the Part B General Enrollment Period.

Click here to learn more about how you might qualify for an SEP.