A Medicare SEP offers an eligible Medicare member a chance to change their plan outside of their
Medicare coverage
Coverage gaps explained: the Medicare Part D "donut hole"If you need to sign up for a Medicare Advantage plan outside of the usual Medicare enrollment periods, a Special Election Period, also called a Special Enrollment Period or SEP, could be the answer. Let’s explore how SEPs work.
What is a Medicare Special Enrollment Period?
How do I qualify for a Medicare SEP?
There are specific rules about who may qualify for an SEP. Here are some common scenarios:
You’ve moved to a new home
- If you’re moving to another city or state where your current Medicare plan isn’t available, you may qualify for an SEP.
- If you’ve recently been released from jail and you’re eligible for Medicare, you may qualify.
Your Medicare Advantage plan is no longer available from your insurance company
- Your insurance company is going to stop offering your current plan at the end of the year. This is sometimes called a non-renewal or termination.
How long is the Special Enrollment Period?
If you have or had health insurance through your job or your spouse’s job, your Special Enrollment Period starts the first month after your
Get more with a Medicare Advantage plan
Medicare Advantage (MA) plans help expand your Medicare coverage beyond Original Medicare. Explore Humana Medicare Advantage plans in your area today!
Exceptional conditions for Medicare SEPs
The Centers for Medicare and Medicaid Services (CMS) has the legal authority to establish SEPs when a person or group of people meet certain exceptional conditions. Some of those conditions include:
- Individuals making MA enrollment requests into or out of employer-sponsored MA plans
- Individuals disenrolling from an MA plan to enroll in the Program of All-inclusive Care for the Elderly (PACE)
- Individuals who dropped a Medicare Supplement insurance plan when they enrolled for the first time in an MA plan and are still in a trial period
- Individuals enrolled in a Special Needs Plan (SNP) who are no longer eligible for the SNP because they no longer meet the specific special needs status
- Non-U.S. citizens who become lawfully present in the U.S.
A special opportunity
Life happens. Whether the next big change represents an exciting adventure or a challenge, we’re here to help keep you covered. Take some time now to explore your
Frequently Asked Questions
The short answer is no. If you’re enrolled in Original Medicare or a Medicare Advantage plan that you want to keep and your plans are still available, you don’t have to do anything, and your coverage will renew automatically. Learn more about
Depending on your choices, if you don’t enroll in certain plans when you’re first eligible, and you don’t have what’s called “creditable coverage” from another source, like an employer, you may pay a penalty to sign up for Medicare later. Take a few minutes to
- Most people who have worked and paid taxes have a $0 premium for Medicare Part A (hospital coverage). If you’re not eligible for premium-free Part A based on your work history, your monthly premium may increase if you don’t purchase Part A coverage when you’re first eligible.
- In most cases, if you don’t sign up for Medicare Part B (medical coverage) when you’re first eligible, you’ll have to pay a penalty—and not just upon enrollment. You’ll continue to pay that penalty for as long as you’re enrolled in Medicare Part B.
- The same applies to Medicare Part D prescription drug plans. If you don’t enroll when first eligible, you’ll pay more for as long as you’re enrolled in a Part D plan.
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