What Is The Medicare Special Enrollment Period?

How Does The Medicare Special Enrollment Period Work?

 

Special Enrollment Periods give you the chance to sign up for Medicare or change your Medicare Advantage or Medicare Part D plan outside the Annual Enrollment Period (from October 15 – December 7).

 

Certain life events and working past 65 can qualify you for a Special Enrollment Period.

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What Is The Medicare Special Enrollment Period?

 

If you already have Original Medicare, you can change your Medicare Advantage or Medicare Part D plan within two months or more after a qualifying life event, depending on the type of event. When you apply, you might need to submit documents that confirm your eligibility to enroll based on the life event you experienced.

 

What Life Events Qualify You For The Special Enrollment Period?

 

Qualifying life events are unexpected events that lead to losing your healthcare coverage. Some common qualifying life events for a Medicare Special Enrollment Period include:

  • Leaving an employer plan or COBRA
  • Your plan stops serving the area where you live or significantly reduces its provider network
  • You move out of your plan’s service area
  • You have a change in eligibility for a qualified State Pharmaceutical Assistance Program
  • You move to a qualified institutional facility, like a nursing home
  • You missed changing plans because of a natural disaster
  • You have a change in eligibility for a Special Needs Plan
  • Your Medicaid eligibility changes

 

Working Past 65: 8-Month Special Enrollment Period

 

If you are 65 and delayed signing up for Original Medicare because you currently have healthcare coverage with an employer, you may qualify for a Special Enrollment Period. This period starts the month after your employer health coverage ends. The duration of your Special Enrollment Period depends on the type of coverage you want.

 

Original Medicare (8 months)
During this 8-month Special Enrollment Period, you can enroll in an Original Medicare plan (Parts A and B) without paying a penalty.

 

Medicare Parts C and D (2 months)
You have 2 months after your employer health coverage ends to sign up for a Medicare Part C (Medicare Advantage) plan or Medicare Part D (prescription drug) plan. It’s important to note that you’ll need to enroll in Original Medicare first. Most Medicare Part C plans include prescription drug coverage. So if you choose a Part C plan, you may not need a Part D plan.

 

Special Enrollment Period For Other Qualifying Life Events: 2 Or More Months

 

If you already have Original Medicare (Part A and Part B), you have two options to sign up for or change your Medicare Part C and/or Part D plans.

 

I am enrolling in a Part C or Part D plan for the first time:

 

Your qualifying life event gives you the opportunity to sign up for a Medicare Part C or Part D plan during the Special Enrollment Period.

 

I need to switch my Part C or Part D plan:

 

If you have a Medicare Part C or Part D plan, your qualifying life event gives you the opportunity to switch your Medicare Part C or Part D plan.

 

Making sure to sign up for or continuing Part D coverage is important as you might have to pay a Part D late enrollment penalty if you don’t maintain your Part D coverage. Most Part C plans include Part D.

Special Enrollment Periods for qualifying life events last for 2 months. There are some exceptions. Visit medicare.gov to learn more.

 

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Anthem Blue Cross is an HMO plan with a Medicare contract. Anthem Blue Cross Life and Health Insurance Company is an LPPO plan with a Medicare contract. Anthem Blue Cross is an HMO SNP plan with a Medicare contract and a contract with the California Medicaid program. Enrollment in Anthem Blue Cross, Anthem Blue Cross Life and Health Insurance Company depends on contract renewal.