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Special Election Period (SEP) - Change of Residence -- Timing and Evidence Requirements

Category: Special Enrollment Periods (SEPs)
Published: Feb, 07 2023 05:02:53


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)






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  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
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  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.