A Special Election Period (SEP) refers to specific timeframes outside of the Annual Enrollment Period when you are eligible to sign up for or change your Medicare insurance due to “special” circumstances. Initial Election Period (IEP) refers to the timeframe for people turning 65 and new to Medicare or those who have been on Medicare prior to age 65 that are now turning 65. Some of the more common SEPs and IEPs include:
[table style=”dark_blue” shadow=”1″]| ENROLLMENT TYPE | ELIGIBILITY |
|---|---|
| Newly Eligible (turning 65) | 7-month Election Period; 3 months before birth month, birth month, 3months after birth month |
| Age-In (turning 65 and was eligible for Medicare prior to age 65) | Same as above |
| Dual Eligible (Medicaid Consumer) | Continuous elections allowed |
| Institutionalized (resides in Skilled Nursing, Long Term Care, etc.) | Continuous elections allowed |
| Change in Residence (permanently moved) | One month before permanent move; 2 months after |
| Loss of Employer Group Coverage | Begins month group allows disenrollment or date COBRA ends. Ends 2 months after group coverage ends |
| Non Renewing Plan (no longer offered in area) | Begins December 8 of that year; ends last day of February of following year |
| Termination of Plan Contract | Begins 2 months before proposed termination date; ends 1 month after date of termination (some variations, check with Medicare) |
| Chronic Condition | Begins upon qualification of disabling condition; ends when enrolled in Special Needs plan |
| 5-Star Rated Plan | Enrollee can change to a 5-Star plan (if one is available in service area) one time per year |
Annual Enrollment Period/Open Enrollment is held each year at the same time:
October 15 thru December 7
The Annual Disenrollment Period is also held annually at the same time. This is when Medicare Advantage enrollees may disenroll from their plan and return to Original Medicare. If a Prescription Drug plan was part of the Medicare Advantage plan, they may purchase a stand-alone Prescription Drug plan:
January 1 thru February 14
There are several other less common SEPs that may be available to you. If you have a question, your best source of information is “Medicare & You.” You may view this publication online at www.medicare.gov/publications/pubs/pdf/10050.pdf. In the states of Washington and Oregon, your VibrantUSA Medicare Insurance Specialists are also an excellent source of information. You may call them toll-free at 866-733-5111 or visit www.vibrantusa.com.
