Medicare Special Enrollment Periods

Events that may open a Special Enrollment Period

You move

Moving out of your plan’s service area, or moving somewhere with plan options your current address did not have, may open a window to change.

You lose other coverage

Losing employer or union coverage, or other creditable coverage, may allow you to enroll without waiting for the next general window.

Your Medicaid status changes

Gaining, losing, or changing Medicaid eligibility may open a window, and people who are dually eligible often have more frequent opportunities to change.

You qualify for Extra Help

Becoming eligible for the Extra Help program with Part D costs may allow a change outside the usual periods.

You move into or out of an institution

Moving into, living in, or leaving a skilled nursing facility or long term care hospital may open a window.

Your plan changes

If your plan leaves the Medicare program, stops serving your area, or its contract is not renewed, you should be notified and given an opportunity to choose another.

You want to join a 5 star plan

Where a plan with a 5 star quality rating is available in your area, there is a window each year to switch into it.

Other circumstances

Other situations can qualify, including certain errors, contract issues, and declared emergencies. If something has changed for you, it is worth asking.

How long a Special Enrollment Period lasts

There is no single answer, because the window depends on which event opened it. Many last about 2 months from the event or from when you were notified, whichever is later. Some are longer, and a few are ongoing for as long as the circumstance applies.

Because the timing varies and the windows are often short, the practical advice is the same in every case. If something has changed, ask sooner rather than waiting, since the window may already be running.