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Medicare Special Enrollment Periods (SEP)

There are Special Enrollment Periods (SEPs) that apply when eligible for delayed enrollment in Medicare Parts A, B, C & D. These SEPs are only available for certain circumstances. Learn more about Medicare Special Enrollment Periods.

A picture describing circumstances to qualify for Medicare's Special Enrollment Period. People who are transitioning from their employer's health insurance or 8 months after coverage ends for Parts A and B.

Special Enrollment for Parts A and B

You can delay enrollment in Medicare Part A (hospital service) and/or Part B (outpatient medical services) if you are employed at a company with more than 20 employees on your 65th birthday. You must also be enrolled in healthcare coverage through your employer, union or spouse’s employer.

A Special Enrollment Period is offered to sign up for Parts A and/or B:

  • If still covered by a health plan through an employer, union or spouse’s employer, OR

  • During the 8 months following the month the employer or union group health plan coverage ends, or when the employment ends (whichever is first).

You may incur a penalty if you choose to delay enrolling in Part A and/or Part B. Learn more about penalties. You may also incur a penalty if you are disabled and working, or have health insurance coverage through a spouse or family member. Under these circumstances, you may be eligible to enroll in Part A and/or B under a Special Enrollment Period.

Special Enrollment for Parts C and D

There are certain circumstances where you may be eligible to enroll in Part C and Part D under a Special Enrollment Period (SEP). For example, you may have delayed enrollment because you received health insurance coverage through your employer, union, or spouse's employer on your 65th birthday. The SEP for Part C (Medicare Advantage Plan) and Part D (drug coverage) is 63 days after the loss of employer healthcare coverage.

The Special Enrollment Period to sign up for Part C (must also be enrolled in Parts A & B) occurs:

  • During the 63 days after the employer or union group health plan coverage ends, or when the employment ends (whichever is first).

The Special Enrollment Period to sign up for Part D (must also enroll in Part A & B) occurs:

  • During the 63 days after employer/union or Veteran’s Administration coverage ends, or when the employment ends (whichever is first).

Certain events trigger other Special Enrollment Periods for Part D plans. For example, switching plans can occur if:

  • There is a move outside area current plan serves, OR

  • Entering, leaving or live in a nursing home, OR

  • Plan changes and no longer serves the area, OR

  • Receiving Extra Help with Medicare prescription drug costs.

Related Content

Understand Medicare Enrollment Periods
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Medicare Advantage Open Enrollment Period
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