If you are qualified to obtain Medicare but you missed your Initial Enrollment Period due to extenuating circumstances, you may qualify for a Medicare Special Enrollment Period.
If you are looking for information about circumstances that can qualify individuals for a Medicare Special Enrollment Period and your particular situation isn’t listed here, please check out Part 1 of this series for more ways to qualify.
Please keep in mind that individuals will only qualify for a Medicare Special Enrollment Period if they are already qualified to obtain Medicare coverage.
Have Health Insurance
There are a couple of scenarios where you have health insurance and may require a Special Enrollment Period. This includes insurance through your own job, a spouse’s job, or a family member’s job while the person is still working, or you lose your group health plan coverage.
It is important to note that COBRA is not considered group health coverage, so this SEP does not apply if you lose COBRA coverage, but gaining COBRA during your SEP also does not affect the end date.
SEP Begins: The month after your Initial Enrollment Period ends.
SEP Ends: 8 months after whichever of these happens first:
- Group coverage ends.
- Employment ends.
How to Sign Up: There are two ways to sign up:
- If you need Part A and B, complete form CMS-18-F-5 and submit it to your local Social Security office.
- If you only need Part B, complete form CMS 40B and submit it to your local Social Security office.
- You can also contact your local insurance agent for assistance.
Coverage Begins: The first day of the month after signup.
Volunteer in a Foreign Country
If you volunteer with an organization in a foreign country, you may need a Special Enrollment Period to obtain Medicare.
SEP Begins: Once one of these situations occurs, your SEP will begin on the first day of the following month:
- You discontinue your volunteer service in a foreign country.
- You lose access to health insurance that provides coverage outside of the U.S.
- The volunteer organization loses its status as tax-exempt.
SEP Ends: 6 months after the start date.
How to Sign Up: There are two ways to sign up:
- If you need Part A and B, complete form CMS-18-F-5 and submit it to your local Social Security office.
- If you only need Part B, complete form CMS 40B and submit it to your local Social Security office.
- You can also contact your local insurance agent for assistance.
Coverage Begins: The first day of the month after signup.
Other Reasons
If you have any extenuating circumstances that prevented you from signing up for Medicare during your Initial Enrollment Period, you can inform Social Security to hopefully be qualified for a Special Enrollment Period.
SEP Begins: On the date that Social Security notifies you of your qualification.
SEP Ends: A minimum of 6 months after the start date (the situation can affect the duration of the SEP).
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 signup.
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.