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.

Moving SEPs

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.

Other Changes

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 and Oregon. 

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