If you find that your prescription costs and healthcare needs have changed, you may now be looking for a more affordable alternative to your current healthcare and prescription coverage.

You may wish to explore some of the following Special Enrollment Periods (SEPs) providing you with an opportunity to change plans outside of the annual Open Enrollment Period.

(1)  2023 Insulin-user SEP:  Medicare has created a new Special Enrollment Period allowing people using insulin products a one-time opportunity to change Medicare plans at any time during 2023.  You can read more at: Q1News.com/386.

(2)  Extra-Help SEP:  If you are eligible for Medicare Part D Extra Help, then you are granted a Special Enrollment Period to change Medicare plans once every three months from January through September with coverage starting on the first day of the month after your enrollment.  To learn more, please see: Q1FAQ.com/716.

Important:  2023 Extra Help qualification limits have changed.  You can click here to for more information about the 2023 Federal Poverty Level (FPL) guidelines and qualifying for Extra Help during 2023.

(3)  5-Star plan SEP:  All Medicare beneficiaries have a once-a-year Special Enrollment Period to switch to a Medicare plan with a 5-Star quality rating.

Although 5-Star plans are not available everywhere, you can use our Medicare Advantage Plan Finder (MA-Finder.com) to check availability of 5-Star Medicare Advantage plans in your county.  Here is an example link for ZIP code 33592: MA-Finder.com/33592 – just look for the 5-Star icon next to the plan name (or use the 5-Star search filter).

Unfortunately, in 2023, there are no 5-Star stand-alone Medicare Part D plans (PDPs) available to the general public; however, there are a few employer/union (EGHP) 5-Star PDPs.

You can click here to read more about using the 5-Star Special Enrollment Period.

(4)  Changes in your health - Chronic Illness SEP:  A person who has developed a chronic health condition may use an SEP to join a Chronic Care Medicare Advantage Special Needs Plan (C-SNP).  Again, please see our MA-Finder at MA-Finder.com - and use the “Chronic Condition” Special Needs Plan filter (checkbox in the search area) to see available plans.  For more information about this SEP, please see:  Q1FAQ.com/35.

(5)  Relocation SEP:  A Special Enrollment Period is available to anyone who moves out of their Medicare plan’s “service area” during the plan year.  The service area for a stand-alone Medicare Part D plan (PDP) is a state or multi-state area and the service area for a Medicare Advantage plan (MA or MAPD) is usually a county, partial-county, or ZIP code area.

Important:  When you move to another service area, you may not find the same Medicare Part D or Medicare Advantage plans – and even plans with the same name may not provide the same coverage as the plan in your previous location.  Please be sure to carefully evaluate your plan options before enrolling.  You can use PDP-Finder.com or MA-Finder.com to review plans available in your new location.

(6)  Long-Term Care SEP:  A Special Enrollment Period is also available to people moving into, or out of, a long-term care (LTC) facility.  You can use our long-term care plan comparison tool: Q1Medicare.com/LTC.

Next steps?  For more information about these and other SEPs that may be available to you, please see our Special Enrollment Period FAQ, contact a Medicare representative at 1-800-633-4227, or contact a local SHIP representative.


Question:  Will I be granted a Special Enrollment Period if my Medicare Advantage plan drops my doctor from the plan network?

Maybe.  Medicare does provide a Special Enrollment Period when a Medicare plan makes “significant” changes to the plan’s healthcare provider network. However, the SEP is granted on a case-by-case basis.  To learn more about qualifying for this SEP, please contact a Medicare representative at 1-800-Medicare.