Enrollment Periods 

For persons on Medicare, there are certain times when you have the ability to sign up or change your Medicare coverage – these are called Enrollment Periods.  Understanding Enrollment Periods, and how they work, is important as it can help you avoid gaps in coverage and/or financial penalties. Over the past couple of years, there have been several changes to these Enrollment Periods. 

General Enrollment Period   CHANGE!

If you did not sign up for Medicare when you were first eligible, and if you do not have a Special Enrollment Period, then you must wait until the General Enrollment Period to enroll in Medicare. The General Enrollment Period is from January 1st to March 31st each year. 

Previously, if you signed up for Medicare during the General Enrollment Period from January 1st to March 31st, your Medicare would not go into effect until July 1st. A recent change shortened that waiting period, so now, if you sign up for Medicare during the General Enrollment Period, it will become effective the start of the next month following your enrollment (instead of having to wait until July 1st). 

Special Enrollment Periods (SEPs) 

Special Enrollment Periods are certain times when you are allowed to make changes to your Medicare enrollments.  Special Enrollment Periods (SEPs) happen when you have a special event in your life, such as a move or loss of other insurance coverage.

Here are some reasons you might be eligible for a Special Enrollment Period:  

Plan Sanctions SEP for Clear Spring SEP  CHANGE!  

The Clear Spring Health Value Rx drug plan was sanctioned last fall by the Centers for Medicare & Medicaid Services due to poor performance.  As a result of this poor performance, Clear Spring will not be providing Part D plans in 2025. If you are still enrolled in the Clear Spring Medicare Part D plan, you have a one-time special opportunity to enroll in a new plan by calling Medicare directly at 1-800-MEDICARE from January 1st to November 30th, 2024.  

  • You can select any other Part D plan that is not rated “below average” or “poor.”
  • 1-800-MEDICARE representatives will assist you with a drug plan comparison to help you find your new drug plan.  

SEP for formerly incarcerated people CHANGE! 

An SEP is available for formerly incarcerated people who didn’t enroll (or re-enroll) in Medicare because they were incarcerated. This SEP begins on the day the person is released from incarceration (if the release date is on or after January 1, 2023). The SEP ends the last day of the 12th month after the person is released from incarceration. Individuals eligible for this SEP may not have to pay any late enrollment penalties. 

Other Key SEPs: A Reminder

There are other changes in your life that may give you a Special Enrollment Period. Ask yourself the following questions to see if you may be eligible for any other SEPs: 

Did you move recently?

  • Many Medicare Advantage or Part D plans are only available if you live in a certain area, so if you move counties or states, you may have a SEP to choose a new plan.  
  • Moving into or out of a skilled nursing facility or long-term care hospital could change the types of Medicare coverage available to you. Some types of Medicare coverage are only available to people in certain facilities, so you could have a SEP to make changes. 

Any time you move, make sure to update your address with the Social Security Administration so you aren’t missing important mailings. 

Did you lose coverage?

  • If you lose/leave employer coverage, that could allow you to make changes to your Medicare coverage.  
  • Sometimes the loss of coverage is beyond your control.  Over the past year, many people who had Medicaid coverage are no longer eligible.  If that applies to you, you will be notified by Health & Human Services via a letter.  (Make sure you are opening & reading all your mail so you aren’t surprised by any coverage changes.)  If this happens to you, it could allow you to make some necessary changes to your Medicare coverage too.     

Did you become eligible for some new benefits?

  • Another reason you might be able to change your Medicare coverage is because you are now eligible for Medicaid or Extra Help (the Part D assistance program).

Depending on the reason for your Special Enrollment Period, you usually have 2 to 6 months to make changes without a payment penalty, so don’t delay if any of these situations apply to you.    

 

For a full list of Special Enrollment Periods on the medicare.gov website, click this link for more details.