With so many different enrollment periods, sometimes it can be difficult to know when you can sign up. There’s the Initial Enrollment Period when you turn 65 years old, the Open Enrollment Period, the Annual Enrollment Period, or a Medicare Advantage Open Enrollment Period. In some cases, but not all, coverage starts on the same date for everyone.
Even for people that have been using Medicare Health Insurance for years, remembering all of these dates can be quite stressful. An often overlooked enrollment period happens when you move, leave a job, or experience other life events that cause a change in your plan. Known as a Special Enrollment Period (SEP), each situation has a specific sign up period.
There are several reasons to move when we get older. Warmer climates are good for health, we want to be closer to family, or perhaps we need assistance with day-to-day activities in a controlled environment. Regardless of the situation, you’ll need to make sure your coverage follows you.
Here is a quick rundown of different moving situations, when you can be eligible for Medicare coverage after a move, and how much time you have to switch or drop your current plans:
Location outside of your current plan: Switch to a new Medicare Advantage (MA) health plan or Medicare Prescription Drug plan or choose to revert to the Original Medicare. If you tell your plan prior to your move, you have one month before the month of the move and two months after the move. Without prior notification of the move, you have two months after the move to change plans. This deals with moves outside of your current county.
Location inside your current plan, but new plans are open to you: Switch to the new MA or Prescription Drug Plan or retain your current plan. If you tell your plan prior to your move, you have one month before the month of the move and two months after the move. Without prior notification of the move, you have two months after the move to change plans.
Moving back to the U.S. after living abroad: Enrolling in Medicare after you return to the U.S.
Once you return to the U.S. and establish residency in the country, you may be eligible for Medicare Part A and/or Part B if you meet the following citizenship and legal permanent residency requirements. You can sign up through the Social Security Administration:
If you turned 65 while living overseas and you didn’t sign up for Medicare when you were first eligible, you may qualify for a Special Enrollment Period that starts when you return to the U.S. and lasts three months. You generally don’t need to pay a late-enrollment penalty if you enroll during this three-month period.
You may also qualify for a Special Enrollment Period if you were living overseas and covered by an employer-based health plan. You can sign up for Medicare Part A and/or Part B anytime as long as either you or your spouse is working and covered through health coverage based on current employment.
If your employment or group coverage ends, your Special Enrollment Period begins after you or your spouse stops working or the group health insurance based on current employment ends (whichever occurs first). This Special Enrollment Period lasts for eight months. Note that COBRA and employer retirement health plans don’t typically qualify you for a Special Enrollment Period because this coverage isn’t based on current employment.
You might also be eligible for a Special Enrollment Period if you were a volunteer serving outside the U.S. for at least 12 months on behalf of a tax-exempt organization and had health insurance coverage for the duration of the service. Your six-month Special Enrollment Period begins when one of the following happens:
- Your volunteer service outside of the U.S. ends.
- The volunteer organization loses its tax-exempt status.
- Your health plan that was providing coverage overseas ends.
- Usually, you don’t pay a late-enrollment penalty if you sign up during a Special Enrollment Period.
Currently live in, recently moved in to, or recently moved out of a healthcare facility (such as a senior home, hospice care, or skilled nursing facility): Choose an MA or Medicare Prescription Drug plan, switch plans, drop plans and revert to Original Medicare, or drop Medicare Prescription Drug plan. This period occurs while you are in the facility and for two full months after you move from the facility.
Recently been released from jail: Enrolling in a Medicare Advantage plan or Medicare Prescription Drug plan for up to two full months after your release.
Loss of Current Coverage
This could be from leaving a job and losing a group health plan, leaving insurance through employer or union, or involuntary loss of creditable drug coverage. This also includes dropping a drug plan via the Medicare Cost Plus or Program of All-inclusive Care for the Elderly (PACE) plan. Note: COBRA ending is not a valid election period to enroll in Medicare Part B. People need to discuss COBRA prior to enrolling if they are 65 and eligible for Medicare. This could cause penalties.
In most cases, you’ll be able to join a Medicare Advantage Plan with drug coverage or a Medicare Prescription Drug Plan. You can make these changes for up to two full months after notification of lost insurance, except in the case of lost Medicaid. If losing Medicaid, you will have up to three full months to join a Medicare Advantage Plan or Medicare Prescription Drug Plan.
If you are able to sign up for better coverage through an employer or a union, you can drop your Medicare plans and start the new coverage when allowed. The same can be done if you’re enrolling in a drug plan as good as Medicare, like VA or Tricare coverage, or joining a Program of All-Inclusive Care for the Elderly plan. Switching to these plans can happen at any time.
There are occasions when an insurance company chooses not to be available in your county, your plan has been dropped by Medicare, or wasn’t renewed. Your ability to sign up for a Medicare Advantage Plan or Medicare Prescription Drug Coverage will be determined by Medicare. Most people will receive notification prior to AEP and then would have an additional length of time to make a plan change based on their plan non-renewing.
Special circumstances, such as qualifying for both Medicare and Medicaid, Extra Help, or Special Needs Plans may mean you need to switch plans, too. Other instances include errors made by a federal employee or faulty information about the quality of coverage offered outside of Medicare.
It’s a lot to think about. Make sure you have a Medicare Insurance agency that understands the difference and knows when you can make those changes.
Find an Agency That Works For You
With so many enrollment periods available to Medicare users, it can be difficult to keep up – especially if they’ve never worked with Medicare before. However, it’s important to know what happens to your coverage when different life events occur, such as moving or leaving a job.
When choosing an agency, think about what you need during this important part of your life. Is it a national agency that may only be able to a few different plans? Or does it make more sense to work with someone local that truly understands local coverages?
As a local independent Medicare health insurance agency, VibrantUSA is able to provide more than 50 plans from more than 30 different insurance carriers. With so many plans to choose from – and so many ways your coverage can be affected – it can be hard to keep track of it all.
VibrantUSA has been working with Medicare users since 2003, taking a personal look at each and every client. No two situations are ever the same, so our agents keep themselves up to date on plan changes, doctor changes, and any federal changes.
We make sure our clients have the best plans, at the best prices, available. Contact us today if you have any questions about Special Enrollment Periods or any other periods. We offer coverage in Washington, Oregon, and Texas.
VibrantUSA is always helpful in answering many of my questions and put me at ease with any and all what ifs and whys I may ask of them.Client Since: 11/16/07
On top of the stress of relocating across the country at age 85, I had additional stress over the changing of insurances after so many years with my former insurance companies. At this age, changes do not come easily! VibrantUSA put me completely at ease and alleviated the stress… They really do care about their clients.Client Since: 12/2/08
We met with a Vibrant agent to discuss several issues and I want to commend her personal service, professionalism and expertise. My wife, Karen, and I thoroughly enjoyed the meeting and will be following up with her early next year as we set our health care insurance coverage during early retirement and then with appropriate Medicare coverage when the time comes.Client Since: 6/30/11
VibrantUSA has assembled a professional staff that listens carefully to each patient and then takes the time needed to be sure all questions are answered. This enables them to recommend coverage choices that really meet our patients’ needs. I trust them to do the right thing.M.D.ABFM, Family Care Network
We are very pleased with the business relationship we share with VibrantUSA. We have found Vibrant to be knowledgeable and helpful in navigating through the plethora of information regarding Medicare insurance related issues for our prospective new residents. On numerous occasions Vibrant has worked with our new resident (and their family members if necessary) to obtain proper insurance and physicians to meet their individual needs. We have also used Vibrant to help our own family members that live locally with their Medicare needs. We have been greatly satisfied with this service too.Executive Director, Emeritus at Fairhaven
I suddenly found myself without health insurance and in a panic… In one 20-minute phone call my fears were totally taken away by VibrantUSA. They talked to Medicare and Social Security and now I am completely covered with Medicare and prescription drug coverage. I would stand on top of the Space Needle and tell everyone about VibrantUSA.Client Since 6/10/09
For over a year, I tried to get a refund for a premium that was charged by a previous health provider in error. The provider ignored me. Then I went to VibrantUSA. With their guidance and assistance with phone calls and letters, I had my full refund within two weeks! Thank you VibrantUSA agents for the time and attention you spent on this matter.Client Since: 12/1/10
Initially we had fears about the Medicare processes, however VibrantUSA has taken the time we needed to relieve any fears and moved us to a comfortable place; which seems amazing given the complicated nature of Medicare.Clients Since: 12/20/07
The world of insurance is not easy to step into when you retire. You, at VibrantUSA, helped that first step be just a little easier, and when things don’t go smoothly with the insurance company, you work it out and make it work. Thank you.Clients Since: 1/1/2008
I moved my father from Montana to Spokane this past summer. It was in a crisis type of situation and quite stressful for me and my father. He had no drug coverage when he came and it was a huge hassle trying to figure out what to do! Once I got referred to VibrantUSA, however, it magically got easy! Not only did the representative help me find a perfect low-cost Advantage plan for my father, we were able to sign him up two months before open enrollment due to my father’s diabetes. The other insurance agents I had talked to didn’t even know we could do the early enrollment. This saved my father about $700.00! Three months later, my father was wrongly disenrolled from his Advantage plan, and, as you can imagine, I got dead ended on a lot of calls trying to resolve it. Once again, I called VibrantUSA and the representative that helped me was a cross between a Medicare genius and a pit bull. She knew exactly what to do and assisted us every step of the way until it was all resolved. I can’t say enough how amazing she was. She solved another big hassle worth hundreds of dollars and saved me from hours of calls and stress.Client Since: 10/1/2010