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Medicare Special Election Period (SEP) Do you know what it is?

Posted on January 23, 2018 at 5:05 PM

A Medicare Special Election Period (SEP) allows you to enroll in Medicare or change your Medicare coverage outside of your Initial Enrollment Period or other enrollment periods without penalty. There are different SEPs to cover different circumstance. A Qualifying Life Event (QLE) means a change in your situation — like getting married, having a baby, or losing health coverage — that can make you eligible for a Special Enrollment Period, allowing you to enroll in health insurance outside the yearly Open Enrollment Period. The special enrollment period generally lasts 60 days before or after the qualifying life event.

If you qualify for Medicare, but you have health insurance through an employer's group health plan, you may be able to delay enrollment in Medicare Part B. When your employer-based coverage ends, you may be eligible for a Special Enrollment Period (SEP) to enroll in Medicare Part B without facing a late-enrollment penalty.  Such a penalty is permanent so enrolling on time is crucial!

Here’s a full list of all life events that qualify for a special enrollment period, organized by those four categories.

Loss of health insurance

Losing job-based coverage

Losing COBRA coverage

Losing individual health coverage for a plan or policy you bought yourself

Losing eligibility for Medicaid or Children’s Health Insurance Program (CHIP)

Losing eligibility for Medicare

Losing coverage through a family member

Changes in household

Getting married

Having a baby, adopting a child, or placing a child for foster care

Getting divorced or legally separated and losing health insurance

Death of someone on your individual health insurance policy

Changes in residence

Moving to a new home in a new zip code or county

Moving to the United States from a foreign country or U.S. territory

Moving to or from the place you attend school, if you’re a student

Moving to or from the place you both live and work, if you’re a seasonal worker

Moving to or from a shelter or other transitional housing

Other qualifying changes

Changes that make you no longer eligible for Medicaid or CHIP

Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder

Becoming newly eligible for Marketplace coverage because you became a U.S. citizen

Leaving incarceration

AmeriCorps VISTA members starting or ending their service

Find out today if you qualify for SEP!


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