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How Do Special Medicare Enrollment Periods Work?

Medicare Special EnrollmentQUALIFYING LIFE EVENTS

Medicare usually places restrictions on when and under what circumstances you can enroll in Medicare and a Part D drug plan or a Medicare Advantage Plan.  You can begin social security as early as 62 or wait until full retirement which is usually 66.  However, you must enroll in Medicare A and B to begin the 1st day of the month in which you turn 65 or else pay a penalty if you delay.  The one major exception to this rule is if you or a spouse are still working and plan to continue with your group health insurance through your employer.  In this case, you can delay your part B Medicare enrollment until you or your spouse retire and are removed from the group insurance.

There are several other common special enrollment periods which will allow you to enroll or make a change to your existing Medicare insurance plan which we will review here, the most common one being a transition in retirement from private employer insurance to Medicare and supplemental or Medicare Advantage coverage.  But, many other transitory circumstances will afford you the ability to make changes to your Medicare plan.

Moving across a county or state lines, for instance, will certainly generate a SEP for you.  Once you move to be sure to contact your existing insurance carrier and notify them of the move.  Then find a good insurance broker to shop new plans in your area.  You will have 63 days from the date of the move in which to make a change to your part D or Medicare Advantage without restriction.  Another common qualifying event for Medicare SEPs is a change in income.

If your income drops below certain thresholds and you qualify for the low-income subsidy, you can also make a change to another Medicare plan within 63 days of this qualifying life event.   Additionally, many seniors who live permanently in other countries and come back to the United States to live are offered a SEP.  Like other SEP’s, you’ll only have 63 days from the move back stateside to activate part B and enroll in a Part D or Medicare advantage plan.

Sometimes a Medicare Advantage plans will decide to exit certain markets and counties at the end of the year.  If your MAPD plan discontinues coverage in your service area Medicare will allow you a SEP for 63 days from January 1st of the following year to make a like change.  Or, you can use this time to go back to original Medicare and pick up a stand-alone part D drug plan and a Medigap plan, also known as a Medicare supplement insurance plan.

Please pay careful attention to your situation and call a trusted advisor if you have questions.  Failure to enroll in Medicare within your allowed time frame can have disastrous consequences and leave you stranded with no insurance for months, or in some cases, years without coverage and can lead to steep penalties that never are removed from your Medicare premiums.  If you’d like a no-obligation consultation with one of our advisers please calls us today.  Or you can complete a contact form for a later time and date.

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Also, check out our Medicare FAQ’s here.

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