What is a Special Election Period (SEP)?
A Special Election Period means that you are allowed to enroll in Medicare Part D without penalty after the Initial Election Period and/or Annual Election Period because you meet certain conditions set forth by the government. Below are the specific situations which might qualify you for a SEP.
You may qualify for a Special Election Period if:
Information from Medicare.gov, Prescription Drug Coverage (2016), Prescription Drug Coverage: Basic Information (2016)
A Special Election Period means that you are allowed to enroll in Medicare Part D without penalty after the Initial Election Period and/or Annual Election Period because you meet certain conditions set forth by the government. Below are the specific situations which might qualify you for a SEP.
You may qualify for a Special Election Period if:
- You are a Hurricane evacuee and reside in certain zip codes as identified by the Federal Emergency Management Agency at the time of the hurricane.
- You move permanently outside your plan's service area.
- You're enrolled in another prescription drug plan or a Medicare Advantage plan whose contract is terminated.
- You are not adequately informed about creditable prescription drug coverage.
- You lose your previous creditable coverage through no action of your own*.
- Your enrollment or non-enrollment is caused by an error by a federal employee or contractor hired by the federal government.
- You were eligible for both Medicare and Medicaid (a "dual eligible") but you lost your dual eligibility status.
- You want to move from an employer-sponsored prescription drug plan to a Medicare Prescription Drug Plan.
- You want to leave your current Medicare Prescription Drug Plan because it was reprimanded by the federal government or the federal government has determined the plan violated a material provision of its Medicare contract in relation to services provided to you.
- You're enrolled in a Cost Plan that isn't renewing its contract with Medicare. This SEP begins 90 calendar days prior to the end of the contract year (i.e., October 1) and ends on December 31 of the same year.
- You want to move from a Program of All-Inclusive Care for the Elderly—PACE—to a Medicare Prescription Drug Plan.
- You live in—or are moving in or out of—a skilled nursing facility, nursing facility, intermediate care facility for the mentally retarded, psychiatric hospital or unit, rehabilitation hospital or unit, long-term care hospital or swing-bed hospital.
- Your Medicare entitlement determination is made retroactively.
- You are not eligible for premium free Part A and enroll in Medicare Part B during the January-March Part B General Enrollment Period.
- You have a low-income subsidy.
- The federal government may authorize other special election periods.
Information from Medicare.gov, Prescription Drug Coverage (2016), Prescription Drug Coverage: Basic Information (2016)
