Frequently Asked Questions about Special Enrollment Periods (SEPs)

A Special Enrollment Period (SEP) allows a Medicare beneficiary to join, switch, or drop their Medicare Part D prescription drug plan (PDP) or Medicare Advantage plan (MA or MAPD) outside of the ann . . .

The 5-Star Special Enrollment Period (SEP) is a once-a-year opportunity to switch from your current Medicare Part D prescription drug plan (PDP) or Medicare Advantage plan (MA or MAPD) to another Med . . .

Yes, in most cases.  When you move out of your Medicare Part D (PDP) or Medicare Advantage (MA or MAPD) plan's service area, you are granted a Special Enrollment Period to join another Medicare . . .

Yes. If you use a Special Enrollment Period (SEP) to change Medicare drug plans during the year, you will find that both the total retail value of your drug purchases and the total value of your out-of-pocket spending (TrOOP) transfer to your new Part D plan.

Yes, you will be granted a Special Enrollment Period (SEP) from the start of the government-declared disaster and continuing 2 full months following the declared end date - or the announced disaster end date - whichever is later.

Maybe. If you are able to change or transfer to another Medicare Advantage plan offered by the same company during the plan year, you may be able to transfer the amount that you have spent for your Medicare Part A and Part B coverage toward your new plan's MOOP limit.

Maybe.  The key is that you must be aware of the type of Medicare plan you currently have and what type of 5-star Medicare plan you are choosing (read more below) as part of the 5-star Special En . . .

No need to wait - you can enroll now into a new Medicare plan.  Most people are not allowed to change Medicare Part D prescription drug or Medicare Advantage plans outside of the annual Open . . .

Maybe. This particular Special Enrollment Period (SEP) is exceptional, and will only be granted if the changes to your provider network are considered as "significant".   You also cannot jus . . .

No.  If you are eligible for the Medicare Part D Extra Help or the Low-Income Subsidy (LIS) program, you are granted a Special Enrollment Period (SEP) that allows you to change Medicare Part D or . . .

A Special Enrollment Period (SEP) allows a Medicare beneficiary to join, switch, or drop their Medicare Part D prescription drug plan (PDP) or Medicare Advantage plan (MA or MAPD or SNP) outside of . . .

No.  The Special Enrollment Period through end of February for Service Area Reduction or Medicare plan cancellation Special Enrollment Period (SAR SEP) would NOT apply. This Special Enrollm . . .

The Centers for Medicare and Medicaid Services (CMS) provides a 3-month Special Enrollment Period (SEP) for people enrolled in Medicare plan (PDP, MA, MAPD) whose contract was terminated by CMS.

Yes. Medicare provides a Special Enrollment Period (SEP) for people who left their Medicare Supplement (Medigap plan) and joined a Medicare Advantage plan for the first time and now within the 12-month trial period wish to return to their Medicare Supplement.

If you are enrolled in a Medicare Advantage plan (MA or MAPD) or Medicare Part D plan (PDP) that is no longer offered next year (and you are not "crosswalked" or transferred  to another Medicare . . .

The Special Election Period (or SEP) for "Change of Residence" becomes available when the beneficiary is moving out of his/her Medicare plan's service area. What is the timing of this Special Ele . . .

Yes.  If you are enrolled in a Medicare Part D or Medicare Advantage plan identified by the Centers for Medicare and Medicaid Services (CMS) as consistently low-performing, CMS will send you a l . . .

Yes. You are permitted to disenroll from your Medicare Part D plan or Medicare Advantage plan during the Annual Open Enrollment Period (AEP - October 15th through December 7th) or outside the AEP usi . . .

Yes. A Medicare beneficiary can use a Special Enrollment Period to join a Medicare Part D plan or Medicare Advantage plan if they lose or leave their employer's health plan (EGHP). A Medicare beneficiary also will be granted an SEP to leave their Medicare plan and join an EGHP.

Yes.  If you are enrolled in a Medicare Part D or Medicare Advantage plan that was sanctioned by the Centers for Medicare and Medicaid Services (CMS or Medicare), then you may be granted a Specia . . .

Yes, you will be granted a Special Enrollment Period (SEP) from the start of the government-declared disaster and continuing 2 full months following the declared end date - or the announced disaster end date - whichever is later.

Yes. A Medicare beneficiary can use a Special Enrollment Period to join a Medicare Part D plan or Medicare Advantage plan if they lose or leave their employer's health plan (EGHP). A Medicare beneficiary also will be granted an SEP to leave their Medicare plan and join an EGHP.

Yes.  If you are enrolled in a Medicare Part D or Medicare Advantage plan that was sanctioned by the Centers for Medicare and Medicaid Services (CMS or Medicare), then you may be granted a Specia . . .

Yes. Medicare provides a Special Enrollment Period (SEP) for people who left their Medicare Supplement (Medigap plan) and joined a Medicare Advantage plan for the first time and now within the 12-month trial period wish to return to their Medicare Supplement.

Yes. You are permitted to disenroll from your Medicare Part D plan or Medicare Advantage plan during the Annual Open Enrollment Period (AEP - October 15th through December 7th) or outside the AEP usi . . .

The Centers for Medicare and Medicaid Services (CMS) provides a 3-month Special Enrollment Period (SEP) for people enrolled in Medicare plan (PDP, MA, MAPD) whose contract was terminated by CMS.

Yes.  Since you joined your Medicare Advantage plan (MAPD) during your Initial Coverage Election Period (ICEP) (similar to your Medicare Part D Initial Enrollment Period (IEP)) surrounding you . . .

A Special Enrollment Period (SEP) allows a Medicare beneficiary to join, switch, or drop their Medicare Part D prescription drug plan (PDP) or Medicare Advantage plan (MA or MAPD or SNP) outside of . . .

Maybe. If you are able to change or transfer to another Medicare Advantage plan offered by the same company during the plan year, you may be able to transfer the amount that you have spent for your Medicare Part A and Part B coverage toward your new plan's MOOP limit.

Yes.  If you are enrolled in a Medicare Part D or Medicare Advantage plan identified by the Centers for Medicare and Medicaid Services (CMS) as consistently low-performing, CMS will send you a l . . .

The 5-Star Special Enrollment Period (SEP) is a once-a-year opportunity to switch from your current Medicare Part D prescription drug plan (PDP) or Medicare Advantage plan (MA or MAPD) to another Med . . .

Yes, Medicare does allow for a Special Enrollment Period (SEP) in exceptional circumstance if you were provided false or incorrect or misleading information during your Medicare plan enrollment.Howeve . . .

Maybe. This particular Special Enrollment Period (SEP) is exceptional, and will only be granted if the changes to your provider network are considered as "significant".   You also cannot jus . . .

No.  If you are eligible for the Medicare Part D Extra Help or the Low-Income Subsidy (LIS) program, you are granted a Special Enrollment Period (SEP) that allows you to change Medicare Part D or . . .

Yes, in most cases.  When you move out of your Medicare Part D (PDP) or Medicare Advantage (MA or MAPD) plan's service area, you are granted a Special Enrollment Period to join another Medicare . . .

Yes. If you use a Special Enrollment Period (SEP) to change Medicare drug plans during the year, you will find that both the total retail value of your drug purchases and the total value of your out-of-pocket spending (TrOOP) transfer to your new Part D plan.

If you are enrolled in a Medicare Advantage plan (MA or MAPD) or Medicare Part D plan (PDP) that is no longer offered next year (and you are not "crosswalked" or transferred  to another Medicare . . .

No.  The Special Enrollment Period through end of February for Service Area Reduction or Medicare plan cancellation Special Enrollment Period (SAR SEP) would NOT apply. This Special Enrollm . . .

Probably not.  But, you may be able to change your plans if you can find another Special Enrollment Period.  Typically, a person has only one chance to make a Medicare plan selection during . . .

Not usually.  Typically, a person only has one chance to make a Medicare plan selection during their Special Enrollment Period (SEP).Once you make your choice of a new Medicare Part D or a Medi . . .