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Have You Recently Moved? You May Qualify for a Medicare Special Enrollment Period

Typically, you are only able to make changes to your Medicare coverage during Medicare’s fall Open Enrollment Period, which runs from October 15 to December 7 each year.

But certain life events, such as moving, may qualify you for a Medicare Special Enrollment Period (SEP). If you qualify for a Medicare SEP, you can change your Medicare coverage outside of the Open Enrollment Period.

Medicare Special Enrollment Periods are unique to you and the events happening in your life. If you qualify for an SEP, you typically have up to two months[1] following the life event to enroll in a new Medicare Advantage plan or return to Original Medicare (Medicare Part A and Part B). If you fail to change your coverage during that time, you will have to wait until the next fall Open Enrollment Period to apply.

During a Medicare Special Enrollment Period, you can typically:

  • Switch from one Medicare Advantage plan to another MA plan
  • Switch from a Medicare Advantage plan back to Original Medicare
  • Add or drop a Medicare Prescription Drug Plan (Medicare Part D)

You cannot enroll in Medicare Part D if you’re enrolled in a Medicare Advantage plan that includes prescription drug coverage. If you change from an MA plan that includes drug coverage to an MA plan that does not, you may add a Part D plan upon enrolling in the new MA plan.

Do You Qualify for an SEP?

There are several types of moves that may qualify you for a Medicare Special Enrollment Period, including if you: 

  • Move somewhere that isn’t in your current Medicare Advantage plan’s service area
  • Move within your current plan’s service area, but have new plan options
  • Move back to the United States after living abroad
  • Move in or out of an institution

3 Things to Know  if You’ve Moved or are Planning to Move

There’s a lot to consider when moving, especially when it comes to your Medicare coverage. Below we outline 3 things you should know to ensure you continue getting the coverage you need, even after you move.

1. Medicare Advantage plan availability varies by location

Not all Medicare Advantage plans are available in every region. If you’re planning to move or have recently moved, we recommend speaking with a licensed insurance agent who can help you find Medicare Advantage plans in your area. You can speak with a licensed insurance agent now at 1-855-710-8630, TTY: 711.

2. A New Medicare Advantage plan may require you to choose a new primary care physician up front

Some Medicare Advantage plans require you to choose a primary care physician upon enrolling in a new plan, especially if your current primary care doctor isn’t in your new plan’s provider network. Some MA plans also require you to get a referral from your primary care physician before seeing a specialist.

When choosing a primary care physician, be sure you choose a physician who: 

  • Accepts new Medicare patients
  • Participates in your plan’s network
  • Partners with your preferred specialists and hospitals

3. Doctors don’t have to accept all Medicare Advantage plans

Not all doctors may be in your plan’s network. If you go to a doctor that does not accept your Medicare Advantage plan, you could be responsible for 100 percent of the costs. Be sure your new doctor accepts your Medicare Advantage plan before scheduling your first visit.

Other Reasons You May Qualify for a Medicare SEP

Moving isn’t the only life event that may qualify you for a Medicare Special Enrollment Period. Some other situations include: 

  • You recently lost your current Medicare coverage
  • Your Medicare plan’s contract has changed or terminated
  • You are eligible for both Medicare and Medicaid
  • You qualify for Extra Help
  • You are losing your eligibility for your Special Needs Plan

To learn more about your Medicare Advantage options, including how to enroll in a new plan during your Special Enrollment Period, speak with a licensed insurance agent at 1-855-710-8630, TTY: 711.

 

[1] According to Medicare.gov “Special circumstances (Special Enrollment Periods), Published May 18, 2018.

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