Special Enrollment Period

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Any time after your Initial Enrollment Period (IEP) at age 65 and you are ending coverage under a group health plan based on current employment (yours or your spouse), you have a SEP to sign up for Part A and/or Part B. The two most common reasons for qualifying for a SEP are:

  • You have retired and are no longer eligible for group coverage.
  • You have a reduction in work hours and are no longer eligible for group coverage.

When this occurs, you can have an 8-month SEP to sign up for Part A and/or Part B that starts at one of these times (whichever happens first):

  • The month after the employment ends.
  • The month after group health plan insurance based on current employment ends.

Usually, you don't pay a late enrollment penalty if you sign up during a SEP.

Please Remember - COBRA and retiree health plans aren't considered coverage based on current employment. You're not eligible for a Special Enrollment Period when that coverage ends. This Special Enrollment Period also doesn't apply to people with End-Stage Renal Disease (ESRD).

In addition, there are many circumstance that may allow you to delay Part B cover due to other insurance or situations. If you have questions, please give us a call at 1-888-335-9498 or you can call CMS at 1-800-Medicare (1-800-633-4227)

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The Special Enrollment Period for Part C Medicare Advantage Plan and Part D drug coverage is 63 days after the loss of employer group health insurance plan or when your employment ends (whichever is first).

Please remember that you must be enrolled in Medicare Part A & B in order to enroll in a Part C Medicare Advantage plan, a Medigap plan or a Part D prescriptions drug coverage.

There are numerous other “special circumstances” that would allow you to sign up for or switch Part C and D plans. For additional information, go to https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/special-circumstances/join-plan-special-circumstances.html#collapse-3193

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You may also sign up for a Medigap plan under what is called a “Medigap Open Enrollment Period”. This is when you are 65 year old or older and are first enrolled in Part B. You have up to 6 months from the end of your employer coverage to sign up for a Medigap plan.

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