A Medicare Special Enrollment Period is the perfect option for anyone who was unable to sign up for their coverage during their Initial Enrollment Period.
Applying for Medicare isn’t always as cut-and-dry as we’d like it to be. Life is messy and unpredictable, which could result in it affecting your ability to sign up for Medicare during your Initial Enrollment Period. If this has happened to you, you may qualify for a Special Enrollment Period, which will allow you to sign up for Medicare coverage outside of your Initial Enrollment Period and the General Enrollment Period without having to pay monthly penalty fees during the course of your coverage.
Please keep in mind that individuals will only qualify for a Medicare Special Enrollment Period if they are already qualified to obtain Medicare coverage.
Loss of Medicaid
If you lose your Medicaid coverage on or after January 1st, you can qualify for a Special Enrollment Period to obtain Medicare coverage before the Annual Enrollment Period.
SEP Begins: Date of notification of coverage loss.
SEP Ends: 6 months after your Medicaid coverage has ceased.
How to Sign Up: Complete the form CMS-10797 and submit it to your local Social Security office or contact your local insurance agent.
Coverage Begins: The first day of the month after you complete signup or the day your Medicaid coverage is concluded.
Natural Disaster
If you were affected by a natural disaster or state of emergency during your Initial Enrollment Period, you can qualify for a Special Enrollment Period. This SEP also applies if your “authorized representative, legal guardian, or caregiver was impacted by a disaster or emergency,” according to Medicare.
SEP Begins: The date of the declaration of disaster by the Federal, state, or local government. If the date on the declaration document is earlier, that is the day the SEP begins.
SEP Ends: 6 months after whichever event occurs later:
- The end date noted on the declaration document.
- The last day of emergency declaration extension.
- The day the governing body revokes the emergency declaration.
How to Sign Up: Complete form CMS-10797 and file it with your local Social Security office or contact your local insurance agent.
Coverage Begins: The first day of the month after signup.
Inaccurate Information
You may qualify for a Special Enrollment Period if you can show that you were provided inaccurate or misleading information by your employer or current health plan.
SEP Begins: On the date that you inform the Social Security Administration that you were provided incorrect information.
SEP Ends: 6 months after the start date.
How to Sign Up: Complete form CMS-10797 and submit it to your local Social Security office or contact your local insurance agent.
Coverage Begins: The first day of the month after signup.
Released From Incarceration
If you were unable to sign up for Medicare during incarceration, you may qualify for a Special Enrollment Period.
SEP Begins: The date of your release from custody.
SEP Ends: The last day of the twelfth month post-release.
How to Sign Up: Complete form CMS-10797 and submit it to your local Social Security office or contact your local insurance agent.
Coverage Begins: The first day of the month after signup. You can also request retroactive coverage back to your release date, but the retroactive coverage can only go back 6 months and cannot be applied to any date before your release.
Contact Aging Benefits Advisory Today!
If you need help navigating the world of senior health insurance, our advisors at Aging Benefits Advisory are here to assist. Take advantage of our free consultation to ensure that you receive the plan for your budget and needs. We specialize in Medicare Advantage, Medicare Supplements, Dental, Vision, and Final Expense insurance for the senior market of Pinellas County, Pasco County, Manatee County, Hillsborough County, Polk County, Sarasota County, Citrus County, and Marion County, Florida. If you would like a free consultation, contact us online or give us a call at 727-266-0355. For more information, follow us on Facebook, Pinterest, and YouTube.