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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.
If you sign up for Part A or Part B during a Special Enrollment Period because of an exceptional situation (like a natural disaster or emergency), 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.
Original Medicare
A fee-for-service health insurance program that has 2 parts: Part A and Part B. You typically pay a portion of the costs for covered services as you get them. Under Original Medicare, you don’t have coverage through a Medicare Advantage Plan or another type of Medicare health plan.
. 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.
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.
Original Medicare
A fee-for-service health insurance program that has 2 parts: Part A and Part B. You typically pay a portion of the costs for covered services as you get them. Under Original Medicare, you don’t have coverage through a Medicare Advantage Plan or another type of Medicare health plan.
.
Drop your Medicare prescription drug coverage.
When?
Your chance to join, switch, or drop coverage lasts as long as you live in the facility and for 2 full months after the month you move out of the facility.
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.
Original Medicare
A fee-for-service health insurance program that has 2 parts: Part A and Part B. You typically pay a portion of the costs for covered services as you get them. Under Original Medicare, you don’t have coverage through a Medicare Advantage Plan or another type of Medicare health plan.
Drop your Medicare drug plan.
When?
Your chance to change 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.
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.
Program of All-inclusive Care for the Elderly (PACE) A special type of health plan that provides all the care and services covered by Medicare and Medicaid as well as additional medically necessary care and services based on your needs as determined by an interdisciplinary team. PACE serves frail older adults who need nursing home services but are capable of living in the community. PACE combines medical, social, and long-term care services and prescription drug coverage.
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.
Switch from your Medicare Advantage Plan or Medicare drug plan to another plan.
When?
Starting 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.
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?
Starts 2 months before the plan's contract with Medicare ends, and ends 1 full month after the contract ends.
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.)
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.
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.
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.
Join a Medicare drug plan. If you choose to sign up for Part A (even though you'll pay a premium), and have Part B, you can join a Medicare Advantage Plan with drug coverage.
When?
Starts once you sign up for Part B and lasts through the first 2 months that you have Part B. Your Part B coverage starts the first day of the month after you sign up.
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 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.)
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.
Original Medicare
A fee-for-service health insurance program that has 2 parts: Part A and Part B. You typically pay a portion of the costs for covered services as you get them. Under Original Medicare, you don’t have coverage through a Medicare Advantage Plan or another type of Medicare health plan.
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.
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.
Join either a Medicare Advantage Plan or a Medicare drug 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 you lose your coverage from the SNP, whichever is earlier.
Original Medicare
A fee-for-service health insurance program that has 2 parts: Part A and Part B. You typically pay a portion of the costs for covered services as you get them. Under Original Medicare, you don’t have coverage through a Medicare Advantage Plan or another type of Medicare health plan.
.
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 from Medicare.
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.
