Special Election Period (SEP) - Change of Residence -- Timing and Evidence Requirements
The Special Election Period (SEP) for "Change of Residence" becomes available when the beneficiary is permanently relocating outside of their Medicare plan's Service Area.
The Service Area can be a state for a stand-alone Medicare Part D plan or a ZIP Code area for a Medicare Advantage plan. Please note that some Medicare Part D plans are in a Service Area that includes multiple states (such as West Virginia and Pennsylvania).
The timing of the Special Election Period:
- begins the month prior to the individual’s permanent move,
- continues during the month of the move and
- two months after the move.
The SEP may begin with either the date of the permanent move or with the date the individual provides notification a move. It is the individual’s responsibility to notify their Medicare Part D plan (PDP) or Medicare Advantage plan (MA or MAPD) and inform the plan that they are permanently moving outside of the plan's Service Area.
Usually, you will need some evidence of the SEP and this might include:
- Voter registration card, driver’s license, tax records, utility bills.
- Documentation of being outside the plan service area over 6 months.
- Application or signed statement from the member indicating they have permanently moved into or out of the previous service area.
How do you find the Medicare Part D or Medicare Advantage plans that are available
in your area?
We have several online tools to help you get an overview of the Medicare Part D plans in your
area. Here are some good ways to find a new plan for next year:
PDP-Finder - Review all
stand-alone Medicare Part D plans (PDPs) available in your state or enter search criteria
to narrow the plan list.
MA-Finder - Review all
Medicare Advantage plans (MAPDs, MAs, and SNPs) available in your state or enter search
criteria to narrow the plan list.
PDP-Wizard -
This tool provides you with a little guided help finding a stand-alone Medicare Part D
plan. Just answer the questions and we will show you Medicare Part D plans generally
meeting your needs.
Ready to change plans?
When you are ready to move, you can ask a Medicare representative for
assistance finding a new Medicare plan in the Service Area where you
will live.
To contact a Medicare representative, call Medicare directly toll-free
at 1-800-633-4227 (1-800-Medicare), select the prescription drug option,
and then choose the option to speak with a Medicare representative or
say "representative" several times during the automated menu options.
Once connected, please explain your situation to a Medicare
representative and ask the Medicare representative to help you find a
Medicare Advantage plan or a Medicare Part D prescription drug plan that
most economically covers your health and medication needs - or you can
ask specific questions about a particular Medicare plan.
As you review plan options, you can ask the representative to provide
you with an estimated annual cost based on your health and medication
needs for any particular Medicare plan.
You can also make sure that the Medicare representative knows about the
pharmacies you use or have available (and explains to you about the
possible cost differences between preferred and non-preferred network
pharmacies).
If you are enrolling into a Medicare Advantage plan, please be sure that
your healthcare providers are included in the plan's network.
If you have found an acceptable Medicare plan, and you are eligible for
enrollment, the Medicare representative can also process your enrollment
into any Medicare Part D or Medicare Advantage plan directly over the
telephone - and the process only takes a few minutes (with an enrollment
confirmation code provided).
View list of other situations creating a Special Election Period (SEP)