Special enrollment period

Let's talk Medicare! Do you qualify for Special Enrollment Period?

Eligibility

You are Medicare-eligible if you are a legal U.S. resident and one of the following applies to you:

  • You are age 65 or older
  • You are any age and have a qualifying permanent disability

Special Enrollment Period (SEP)

 This is a period when Medicare recipients may change medical and prescription drug coverage outside of AEP, if they meet certain requirements and have a qualifying event, such as moving to a new service area or leaving an employer-based plan.

Qualifying events can include:

  • I moved to a new address that isn't in my plan's service area.
  • 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.
  • I moved back to the U.S. after living outside the country.
  • I just moved into, currently live in, or just moved out of an institution (like a skilled nursing facility or long-term care hospital).
  • I'm released from jail. 
  • I'm no longer eligible for Medicaid.
  • I left coverage from my employer or union (including COBRA coverage).
  • 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 creditable.
  • I had drug coverage through a Medicare Cost Plan and I left the plan.
  • I dropped my coverage in a Program of All-inclusive Care for the Elderly (PACE) plan.
  • I have a chance to enroll in other coverage offered by my employer or union.
  • I have or am enrolling in other drug coverage as good as Medicare prescription drug coverage (like TRICARE or VA coverage).
  • I enrolled in a Program of All-inclusive Care for the Elderly (PACE) plan.
  • Medicare takes an official action (called a "sanction") because of a problem with the plan that affects me.
  • Medicare ends (terminates) my plan's contract.
  • My Medicare Advantage Plan, Medicare Prescription Drug Plan, or Medicare Cost Plan's contract with Medicare isn't renewed.
  • I'm eligible for both Medicare and Medicaid.
  • I qualify for Extra Help paying for Medicare prescription drug coverage.
  • I'm enrolled in a State Pharmaceutical Assistance Program (SPAP) or lose SPAP eligibility.
  • I dropped a Medigap policy the first time I joined a Medicare Advantage 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 condition.
  • 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.
  • I joined a plan, or chose not to join a plan, due to an error by a federal employee.
  • I wasn't properly told that my other private drug coverage wasn't as good as Medicare drug coverage (creditable coverage).
  • I wasn't properly told that I was losing private drug coverage that was as good as Medicare drug coverage (creditable coverage).

Questions about your qualifications? Contact Prevea360 Medicare Advantage Sales Support at 1-877-234-0126 (TTY: 711). For more information about Medicare eligibility and enrollment policies and limitations, visit medicare.gov or call 1-800-MEDICARE (1-800-633-4227).



What enrollment period do you qualify for?

Initial enrollment period

Annual enrollment period

Open enrollment period

Special enrollment period

View our Medicare disclaimer.
H9096_prevea360.com
Updated: 7/22/2021