You can make changes to your Medicare Advantage and Medicare prescription drug coverage when certain events happen in your life, like if you move or you lose other insurance coverage. These chances to make changes are called Special Enrollment Periods (SEPs). Rules about when you can make changes and the type of changes you can make are different for each SEP.
You change where you live
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You move to a new address that isn't in your plan's service area.
What can you do?
Switch to a new Medicare Advantage Plan or Medicare Prescription Drug Plan.
When?
If you tell your plan before you move, your chance to switch plans begins the month before the month you move and continues for 2 full months after you move.
If you tell your plan after you move, your chance to switch plans begins the month you tell your plan, plus 2 more full months.
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You move to a new address that’s still in your plan's service area, but you have new plan options in your new location.
What can you do?
Switch to a new Medicare Advantage Plan or Medicare Prescription Drug Plan.
When?
If you tell your plan before you move, your chance to switch plans begins the month before the month you move and continues for 2 full months after you move.
If you tell your plan after you move, your chance to switch plans begins the month you tell your plan, plus 2 more full months.
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You move back to the U.S. after living outside the country.
What can you do?
Join a Medicare Advantage Plan or Medicare Prescription Drug Plan.
When?
Your chance to join lasts for 2 full months after the month you move back to the U.S.
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You just moved into, currently live in, or just moved out of an institution (like a skilled nursing facility or long-term care hospital).
What can you do?
- Join a Medicare Advantage Plan or Medicare Prescription Drug Plan.
- Switch from your current plan to another Medicare Advantage Plan or Medicare Prescription Drug Plan.
- Drop your Medicare Advantage Plan and return to Original Medicare.
- Drop your Medicare prescription drug coverage.
When?
Your chance to join, switch, or drop coverage lasts as long as you live in the institution and for 2 full months after the month you move out of the institution.
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You're released from jail.
What can you do?
Join a Medicare Advantage Plan or Medicare Prescription Drug Plan.
When?
Your chance to join lasts for 2 full months after the month you're released from jail.
You lose your current coverage
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You're no longer eligible for Medicaid.
What can you do?
- Join a Medicare Advantage Plan or Medicare Prescription Drug Plan.
- Switch from your current plan to another Medicare Advantage Plan or Medicare Prescription Drug Plan.
- Drop your Medicare Advantage Plan and return to Original Medicare.
- Drop your Medicare prescription drug coverage.
When?
Your chance to change lasts for 2 full months after the month you find out you're no longer eligible for Medicaid.
If you lose your coverage for the following year, your chance to change is between January 1–March 31.
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You leave coverage from your employer or union (including COBRA coverage).
What can you do?
Join a Medicare Advantage Plan or Medicare Prescription Drug Plan.
When?
Your chance to join lasts for 2 full months after the month your coverage ends.
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You involuntarily lose other drug coverage that's as good as Medicare drug coverage (creditable coverage), or your other coverage changes and is no longer creditable.
What can you do?
Join a Medicare Advantage Plan with drug coverage or a Medicare Prescription Drug Plan.
When?
Your chance to join lasts for 2 full months after the month you lose your creditable coverage or you're notified of the loss of creditable coverage, whichever is later.
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You have drug coverage through a Medicare Cost Plan and you leave the plan.
What can you do?
Join a Medicare Advantage Plan with drug coverage or a Medicare Prescription Drug Plan.
When?
Your chance to join lasts for 2 full months after the month you lose your creditable coverage (Medigap) or you're notified of the loss of creditable coverage, whichever is later.
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You drop your coverage in a Program of All-Inclusive Care for the Elderly (PACE) plan.
What can you do?
Join a Medicare Advantage Plan or Medicare Prescription Drug Plan.
When?
Your chance to join lasts for 2 full months after the month you drop your Programs of All-inclusive Care for the Elderly (PACE) plan.
You have a chance to get other coverage
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You have a chance to enroll in other coverage offered by your employer or union.
What can you do?
Drop your current Medicare Advantage Plan or Medicare Prescription Drug Plan to enroll in the private plan offered by your employer or union.
When?
Whenever your employer or union allows you to make changes in your plan.
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You have or are enrolling in other drug coverage as good as Medicare prescription drug coverage (like TRICARE or VA coverage).
What can you do?
Drop your current Medicare Advantage Plan with drug coverage or your Medicare Prescription Drug Plan.
When?
Anytime.
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You enroll in a Program of All-Inclusive Care for the Elderly (PACE) plan.
What can you do?
Drop your current Medicare Advantage Plan or Medicare Prescription Drug Plan.
When?
Anytime.
Your plan changes its contract with Medicare
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Medicare takes an official action (called a "sanction") because of a problem with the plan that affects you.
What can you do?
Switch from your Medicare Advantage Plan or Medicare Prescription Drug Plan to another plan.
When?
Your chance to switch is determined by Medicare on a case-by-case basis.
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Medicare ends (terminates) your plan's contract.
What can you do?
Switch from your Medicare Advantage Plan or Medicare Prescription Drug Plan to another plan.
When?
Your chance to switch starts 2 months before and ends 1 full month after the contract ends.
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Your Medicare Advantage Plan, Medicare Prescription Drug Plan, or Medicare Cost Plan's contract with Medicare isn't renewed.
What can you do?
Join another Medicare Advantage Plan or Medicare Prescription Drug Plan.
When?
October 15–the last day in February.
Other special situations
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You're eligible for both Medicare and Medicaid.
What can you do?
Join, switch, or drop your Medicare Advantage Plan or Medicare prescription drug coverage.
When?
Anytime.
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You qualify for Extra Help paying for Medicare prescription drug coverage.
What can you do?
Join, switch, or drop Medicare prescription drug coverage.
When?
Anytime.
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You're enrolled in a State Pharmaceutical Assistance Program (SPAP) or lose SPAP eligibility.
What can you do?
Join either a Medicare Prescription Drug Plan or a Medicare Advantage Plan with prescription drug coverage.
When?
Once during the calendar year.
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You dropped a Medigap policy the first time you joined a Medicare Advantage Plan.
What can you do?
Drop your Medicare Advantage Plan and enroll in Original Medicare. You'll have special rights to buy a Medigap policy.
When?
Your chance to drop your Medicare Advantage Plan lasts for 12 months after you join the Medicare Advantage Plan for the first time.
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You have a severe or disabling condition, and there’s a Medicare Chronic Care Special Needs Plan (SNP) available that serves people with your condition.
What can you do?
Join a Medicare Chronic Care Special Needs Plan (SNP).
When?
You can join anytime, but once you join, your chance to make changes using this SEP ends.
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You're enrolled in a Special Needs Plan (SNP) and no longer have a condition that qualifies as a special need that the plan serves.
What can you do?
Switch from an SNP to a Medicare Advantage Plan or Medicare Prescription Drug Plan.
When?
You can choose a new plan starting from the time you lose your special needs status, up to 3 months after your SNP's grace period ends.
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You joined a plan, or chose not to join a plan, due to an error by a federal employee.
What can you do?
- Join a Medicare Advantage Plan with drug coverage or a Medicare Prescription Drug Plan.
- Switch from your current plan to another Medicare Advantage Plan with drug coverage or a Medicare Prescription Drug Plan.
- Drop your Medicare Advantage Plan with drug coverage and return to Original Medicare.
- Drop your Medicare prescription drug coverage.
When?
Your chance to change coverage lasts for 2 full months after the month you get a notice of the error from Medicare.
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You weren't properly told that your other private drug coverage wasn't as good as Medicare drug coverage (creditable coverage).
What can you do?
Join a Medicare Advantage Plan with drug coverage or a Medicare Prescription Drug Plan.
When?
Your chance to join lasts for 2 full months after the month you get a notice of the error from Medicare.
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You weren't properly told that you were losing private drug coverage that was as good as Medicare drug coverage (creditable coverage).
What can you do?
Join a Medicare Advantage Plan with drug coverage or a Medicare Prescription Drug Plan.
When?
Your chance to join lasts for 2 full months after the month you get a notice of the error from Medicare.
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