Special Enrollment Periods

You can make changes to your Medicare Advantage and Medicare drug coverage when certain events happen in your life, like if you move or you lose other coverage. These chances to make changes are called Special Enrollment Periods. The types of changes you can make and the timing depend on your life event. If you have questions or need help making enrollment changes, call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. 

Starting January 1, 2024, if you sign up for Part A and/or Part B because of an exceptional situation, you’ll have 2 months to join a Medicare Advantage Plan (with or without drug coverage) or a Medicare drug plan (Part D). Your coverage will start the first day of the month after the plan gets your request to join. 

You change where you live

I moved to a new address that isn't in my plan's service area.

What can I do?

Switch to a new Medicare Advantage Plan or Medicare drug plan.

If you’re in a Medicare Advantage Plan and you move outside your plan’s service area, you can also choose to return to Original Medicare . If you don’t join a new Medicare Advantage Plan during the time explained below, you’ll be enrolled in Original Medicare when you’re disenrolled from your old Medicare Advantage 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.

I moved to a new address that's still in my plan's service area, but I have new plan options in my new location.

What can I do?

Switch to a new Medicare Advantage Plan or Medicare 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.

I moved back to the U.S after living outside the country.

What can I do?

Join a Medicare Advantage Plan or Medicare drug plan.

When?

Your chance to join lasts for 2 full months after the month you move back to the U.S.

I 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 I do?

  • Join a Medicare Advantage Plan or Medicare 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 leave the institution.

I'm released from jail.

What can I do?

Join a Medicare Advantage Plan or Medicare drug plan.

When?

If you kept paying for your Part A and Part B coverage while you were in jail, you have 2 full calendar months after you're released from jail to join a plan. You have to sign up for Medicare before you can join a plan.

Get more information on how Medicare works if you’re in jail or incarcerated.

You lose your current coverage

I'm no longer eligible for Medicaid.

What can I do?

  • Join a Medicare Advantage Plan or Medicare drug plan.
  • Switch from your current plan to another Medicare Advantage Plan or Medicare 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 3 full months from either the date you're no longer eligible or notified, whichever is later.

I left coverage from my employer or union (including COBRA coverage).

What can I do?

Join a Medicare Advantage Plan or Medicare drug plan.

When?

Your chance to join lasts for 2 full months after the month your coverage ends.

I involuntarily lose other drug coverage that's as good as Medicare drug coverage (creditable coverage), or my other coverage changes and is no longer credible. 

What can I do?

Join a Medicare Advantage Plan with drug coverage or a Medicare drug plan.

When?

Your chance to join lasts 2 full months after the month you lose your creditable coverage, or for 2 full months after you're notified that your current coverage is no longer creditable, whichever is later.

I had drug coverage through a Medicare Cost Plan and I left the plan.

What can I do?

Join a Medicare drug plan.

When?

Your chance to join lasts for 2 full months after you drop your Medicare Cost Plan.

I dropped my coverage in a Program of All-inclusive Care for the Elderly (PACE) plan.

What can I do?

Join a Medicare Advantage Plan or Medicare drug plan.

When?

Your chance to join lasts for 2 full months after the month you drop your Program of All-inclusive Care for the Elderly (PACE) plan. 

You have a chance to get other coverage

I have a chance to enroll in other coverage offered by my employer or union. 

What can I do?

Drop your current Medicare Advantage Plan or Medicare 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.

I have or am enrolling in other drug coverage as good as Medicare drug coverage (like TRICARE or VA coverage).

What can I do?

Drop your current Medicare Advantage Plan with drug coverage or your Medicare drug plan.

When?

Anytime.

I enrolled in a Program of All-inclusive Care for the Elderly (PACE) plan. 

What can I do?

Drop your current Medicare Advantage Plan or Medicare drug plan.

When?

Anytime.

Your plan changes its contract with Medicare

Medicare takes an official action (called a "sanction") because of a problem with the plan that affects me.

What can I do?

Switch from your Medicare Advantage Plan or Medicare drug plan to another plan.

When?

Your chance to switch is determined by Medicare on a case-by-case basis.

Medicare ends (terminates) my plan's contract.

What can I do?

Switch from your Medicare Advantage Plan or Medicare drug plan to another plan.

When?

Your chance to switch starts 2 months before and ends 1 full month after the contract ends.

My Medicare Advantage Plan, Medicare Prescription Drug Plan, or Medicare Cost Plan's contract with Medicare isn't renewed. 

What can I do?

Join another Medicare Advantage Plan or Medicare drug plan.

When?

December 8–the last day in February.

Other special situations

I'm eligible for both Medicare and Medicaid.

What can I do?

Join, switch, or drop your Medicare Advantage Plan or Medicare drug coverage.

When?

One time during each of these periods:

  • January–March
  • April–June
  • July–September

If you make a change, it will take effect on the first day of the following month.

I qualify for Extra Help paying for Medicare prescription drug coverage.

What can I do?

Join, switch, or drop Medicare drug coverage.

When?

Most people with Medicare can only make changes to their drug coverage at certain times of the year. If you have Medicaid or receive Extra Help, you may be able to make changes to your coverage one time during each of these periods:

  •  January – March
  •  April – June
  •  July – September

If you make a change, it will begin the first day of the following month.

I'm enrolled in a State Pharmaceutical Assistance Program (SPAP).

What can I do?

Join either a Medicare drug plan or a Medicare Advantage Plan with drug coverage.

When?

Once during the calendar year.

I'm enrolled in a State Pharmaceutical Assistance Program (SPAP) and I lost SPAP eligibility.

What can I do?

Join either a Medicare drug plan or a Medicare Advantage Plan with drug coverage.

When?

Your chance to switch starts either the month you lose eligibility or the month you're notified of the loss, whichever is earlier. It ends 2 months after either the month of the loss of eligibility or notification of the loss, whichever is later.

I dropped a Medigap policy the first time I joined a Medicare Advantage Plan and I'm still in a "trial period" and eligible for guaranteed issue of a Medigap policy.

What can I 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.

I want to join a plan with a 5-star quality rating.

What can I do?

If a Medicare Advantage Plan, Medicare drug plan, or Medicare Cost Plan with a 5-star rating is available in your area, you can use the 5-star Special Enrollment Period to switch from your current Medicare plan to a Medicare plan with a “5-star” quality rating.   What does a "5-star" quality rating mean?

If you move from a Medicare Advantage Plan that includes prescription drug coverage to a stand-alone Medicare drug plan, you’ll be disenrolled from your Medicare Advantage Plan, including the health benefit. You’ll be returned to Original Medicare for coverage of your health services. You can only switch to a 5-star Medicare drug plan if one is available in your area.

If you move from a Medicare Advantage Plan that has drug coverage to a 5‑star Medicare Advantage Plan that doesn’t have drug coverage, you may lose your prescription drug coverage. You’ll have to wait until your next enrollment opportunity to get drug coverage, and you may have to pay a Part D late enrollment penalty. 

When?

You can use this Special Enrollment Period only once between December 8 and November 30 the following year.

I have a severe or disabling condition, and there's a Medicare Chronic Care Special Needs Plan (SNP) available that serves people with my condition.

What can I 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.

I'm 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 I do?

Switch from a Special Needs Plan (SNP) to a Medicare Advantage Plan or Medicare 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.

I joined a plan, or chose not to join a plan, due to an error by a federal employee.

What can I do?

  • Join a Medicare Advantage Plan with drug coverage or a Medicare 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.

I wasn't properly told that my other private drug coverage wasn't as good as Medicare drug coverage (creditable coverage).

What can I 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 or your plan.

I wasn't properly told that I was losing private drug coverage that was as good as Medicare drug coverage (creditable coverage).

What can I 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 or your plan.

Other exceptional circumstances

There are other situations where you might qualify for a special enrollment period, like if you joined a plan based on misleading or incorrect information from a plan representative or State Health Insurance Assistance Program, or you’re notified that there’s a significant change in your plan’s provider network. These special enrollment periods are evaluated on a case-by-case basis.

What can I do?

  • Join a Medicare Advantage Plan or Medicare 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.

 

There are other events that may qualify you for a Special Enrollment Period. If you think you have an exceptional circumstance that isn’t listed on this page call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.