Special Enrollment Periods

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 (with or without drug coverage) or Medicare drug plan.

You can also choose to go back to Original Medicare if you’re in a Medicare Advantage Plan and you move outside your plan’s service area. If you move outside your old plan’s service area and don’t join a new Medicare Advantage Plan during this Special Enrollment Period, you’ll be enrolled in Original Medicare when you’re dropped from your old Medicare Advantage Plan. 

When?

Your chance to switch begins when you move and continues for 2 full months after you move. 

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. 

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 (with or without drug coverage) or Medicare drug plan.  

You can also choose to go back to Original Medicare if you’re in a Medicare Advantage Plan and you move outside your plan’s service area. If you move outside your old plan’s service area and don’t join a new Medicare Advantage Plan during this Special Enrollment Period, you’ll be enrolled in Original Medicare when you’re dropped from your old Medicare Advantage Plan. 

When?

Your chance to switch begins when you move and continues for 2 full months after you move. 

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. 

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 live in, or recently moved out of an institution (like a nursing home or rehabilitation 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 drug plan.
• Drop your Medicare Advantage Plan and return to  Original Medicare .
• Drop your Medicare 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 move out of the institution.

I was in jail or incarcerated and have been released.

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 Part A and/or Part B 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 with drug coverage or Medicare drug plan.
• Switch from your current plan to another Medicare Advantage Plan with drug coverage or Medicare drug plan.
• Drop your Medicare Advantage Plan with drug coverage and return to Original Medicare.
• Drop your Medicare drug plan.

When? 

Your chance to change plans lasts for 3 full months from either the date you're no longer eligible or the date you're notified you're no longer eligible, 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 the month 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 join 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 join other coverage.

I have or am enrolling in other creditable prescription 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. You'll be enrolled in Original Medicare after you drop your Medicare Advantage Plan with drug coverage.
• Switch from a Medicare Advantage Plan with drug coverage to a Medicare Advantage Plan without drug coverage.

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 I'm in.

What can I do?

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

When?

Your chance to switch begins when the sanction is imposed and is available until the sanction ends or until you switch to another plan, whichever happens first.

I'm in a plan that the state recently took over because of financial issues.

What can I do?

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

When?

The month the state action is effective and lasting until the state action is no longer in effect or until you join another plan, whichever occurs first.  

Medicare ends (terminates) my plan's contract, or my plan ends its contract with Medicare.

What can I do?

Switch from your Medicare Advantage Plan or Medicare drug plan to another plan. You'll be enrolled in Orignal Medicare if you don't join another Medicare Advantage Plan before your current plan ends.

When?

Your chance to switch starts 2 months before the plan's contract with Medicare ends, and ends 1 full month after the contract ends.

My Medicare Advantage Plan, Medicare drug plan, or Medicare Cost Plan's contract with Medicare isn't renewed. 

What can I do?

Switch from your Medicare Advantage Plan, Medicare drug plan, or Medicare Cost Plan to another plan. You’ll be enrolled in Original Medicare if you don’t join another Medicare Advantage Plan before your current plan ends. 

When?

Between December 8 and the last day in February of the following year.

Other special situations

I have Medicare and Medicaid, or I get Extra Help paying for Medicare drug coverage.

What can I do?

• Switch to a different Medicare drug plan.
• Drop a Medicare Advantage Plan with drug coverage and return to Original Medicare by joining a stand-alone Medicare drug plan.

This Special Enrollment Period isn't available to you if you're identified as a "potential at-risk beneficiary" or "at-risk beneficiary" under a Part D drug management program. You'll get a letter from your plan if they identify you as "at-risk" or "potentially at-risk."

When?

If you have Medicaid or get Extra Help, you can make changes to your coverage once a calendar month. The change will take effect on the first day of the next month. 

(Note: Most people with Medicare can only make changes to their drug coverage at certain times of the year.) 

I have Medicare and get full Medicaid benefits.

What can I do?

Join or switch to a plan that can help coordinate coverage between my Medicare and Medicaid managed care plans (called an integrated Dual Eligible Special Needs Plan (D-SNP)) if one’s available in my area.  What's an integrated D-SNP?

When?

If you qualify for this Special Enrollment Period, you can join or switch to an integrated D-SNP once a calendar month. The change will take effect on the first day of the next month.

Remember, not all D-SNPs are integrated. Contact the D-SNP plan you're interested in for more information and to find out how it works. You can also contact 1-800-MEDICARE for a list of integrated D-SNPs.

I found out that I won't be eligible for Extra Help next year.

What can I do?

• Join a Medicare Advantage Plan with drug coverage or Medicare drug plan.
• Switch from your current plan to another Medicare Advantage Plan with drug coverage or Medicare drug plan.
• Drop your Medicare Advantage Plan and return to Original Medicare.
• Drop your Medicare drug plan.

When?

Your chance to change plans lasts for 3 full months from either the date you're no longer eligible or the date you're notified you're no longer eligible, whichever is later. 

I can't get premium-free Part A (Hospital Insurance) coverage, and I signed up for Medicare Part B (Medical Insurance) during the Part B General Enrollment Period (January 1–March 31).

What can I do?

Join a Medicare drug plan, or if you have Part A and Part B, you can join a Medicare Advantage Plan with drug coverage.

When?

Once you submit your Part A and/or Part B application through the first 2 months of your enrollment.

Your Part B coverage starts the first day of the month after you sign up.

I have Medicare and Medicaid, or I get Extra Help paying for Medicare drug coverage.

What can I do?

• Join or switch to a different Medicare drug plan.
• Drop a Medicare Advantage Plan with drug coverage and return to Original Medicare by joining a stand-alone Medicare drug plan.

This Special Enrollment Period isn't available to you if you're identified as a "potential at-risk beneficiary" or "at-risk beneficiary" under the requirements for Part D drug management programs. You’ll get a letter from your plan if they identify you as “at-risk” or “potentially at-risk.”

When?

If you have Medicaid or get Extra Help, you can make changes to your coverage once a calendar month. The change will take effect on the first day of the next month. 

(Note: Most people with Medicare can only make changes to their drug coverage at certain times of the year.) 

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'm in a plan that's had a star rating of less than 3 stars for the last 3 years.

What can I do?

Switch to a Medicare Advantage Plan or Medicare drug plan.

When?

Any time you're in the low-performing plan. 

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

What can I do?

Join a Medicare Chronic Care Special Needs Plan that serves people with my condition.

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?

Join either a Medicare drug plan or another type of Medicare Advantage Plan.

When?

Your chance to switch starts the month you lose your special needs status. It ends when you join another plan or 3 calendar months after the effective date of your involuntary enrollment from the SNP, whichever is earlier.

I joined a plan, or chose not to join a plan, due to an error, misrepresentation, or inaction by a federal employee or any person authorized by the Federal government to act on its behalf.

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 drug plan.
• Drop your Medicare Advantage Plan with drug coverage and return to  Original Medicare .
• Drop your Medicare drug plan.

When?

Your chance to change coverage lasts for 2 full months after the month you get a notice of the error, misrepresentation, or inaction from Medicare.

I wasn't properly told by my plan 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 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 by my plan 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 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 live in the service area of one or more Medicare Advantage Plans or Medicare drug plans with an overall quality rating of 5 stars on Medicare.gov

What can I do?

Join a Medicare Advantage Plan, Medicare Cost Plan, or Medicare drug plan with an overall quality rating of 5 stars. 

When?

One time between December 8 of the year before the plan year and November 30 of the plan year. 

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.

When?

You’ll have 2 months to join a plan or switch to another plan.

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.