Wise Insurance Logo

Call Us

How to Qualify for a Special Enrollment Period

Qualifying for Special Enrollment Period

Special Enrollment Periods allow you to sign up for a Medicare plan or change a Medicare plan after the Initial or General Enrollment Periods.

The Initial Enrollment Period starts three months before turning 65 and ends three months after turning 65. If you missed your Initial Enrollment, you can also enroll during the General Enrollment Period from January 1 to March 31, but you may face late enrollment penalties. However, some circumstances may stop one from enrolling during both periods. As a result of this, Medicare may allow you to change your coverage or enroll in a new plan under some circumstances. This is known as the Special Enrollment Period.

What You Can Do

During the Special Enrollment Period, you can move from Medicare Advantage back to Original Medicare and vice versa. You can also switch between Medicare Advantage plans, add, change, or drop your Part D coverage, or drop your Medicare coverage in favor of an employee health plan.

How to Qualify

There are specific circumstances that may qualify you for a Special Enrollment Period:

  • If you move and your new location is not within your plan’s service area, you qualify for a Special Enrollment Period to enable you to switch to a different Part C or Part D plan or switch to Original Medicare.
  • If you change your address and new plan options are available, you can switch to another Part C or Part D plan during the Special Enrollment Period.
  • If your employment or your group health plan stops, you may qualify for an SEP to enable you to sign up for Original Medicare.
  • You may qualify for a Special Enrollment Period if you’re no longer eligible for Medicaid. During this period, you can enroll for Part C or Part D, or switch between Medicare Advantage plans.
  • If you lose your coverage as a result of unavoidable events, you can join a Part C or Part D plan during the Special Enrollment Period.
  • You may qualify for a Special Enrollment Period if Medicare is ending your plan. This will let you switch to a different Medicare plan.

These are some of the ways to qualify for a Special Enrollment Period. If you think you may qualify for a Special Enrollment Period, ensure you contact Medicare to ascertain your eligibility and to find out when your Special Enrollment Period will start. In most cases, if you qualify for a Special Enrollment Period, you will not pay the late enrollment penalty for that plan. However, it is important to contact Medicare as soon as you notice any change that may require a Special Enrollment Period.

Contact Wise Up Financial

For more information on Special Enrollment Periods or other Medicare enrollment periods, contact us at 832-308-0123.

Share this article

Table of Contents

Still Have Questions?

We strive to educate and empower our clients to make the best decisions for their health insurance coverage.

Still Have Questions?

If you’ve enrolled in Medicare and want to learn more about your coverage, then we’re here to help. Feel free to reach out to us today and we will find a time to talk more about your specific coverage and the ways you can use it.

Recent Blog Posts