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Let SelectQuote help you navigate Medicare’s Special Enrollment Period.
Our licensed insurance agents can help you better understand Medicare Advantage plans and review the coverage options that may be available to you. There’s no obligation to enroll.
Medicare Special Enrollment Period (SEP): Rules and Qualifying Events
A Medicare Special Enrollment Period (SEP) is a limited time outside the standard Medicare enrollment windows when you can enroll in or change plans due to specific qualifying life events, such as moving, losing creditable employer coverage, or qualifying for financial assistance like Extra Help. The most important feature of SEPs is the ability to make necessary coverage changes and, in some cases, avoid late enrollment penalties.
Because SEP windows are often time-sensitive and tied to specific events, understanding your eligibility can help you avoid gaps in coverage and costly penalties. Acting quickly—and with the right guidance—can make all the difference in securing coverage.
Common Medicare SEP Qualifying Events
There are several types of Medicare Special Enrollment Periods, each with different qualification standards. Below are some of the most common qualifying events:
Moving Out of Your Plan's Service Area
Moving to a new address that isn’t in your current Medicare plan’s service area
Moving to a new location where new Medicare plan options are available, even if your current plan still covers your new address
Returning to the U.S. after living outside the country
Moving in or out of a skilled nursing facility or long-term care hospital
Being released from jail
Losing Creditable Coverage or Other Entitlement
You’re no longer eligible for Medicaid
You left employer or union coverage (including COBRA)
You involuntarily lost drug coverage that’s as good as Medicare drug coverage
You had drug coverage through a Medicare Cost plan and left the plan
You dropped coverage in a Program of All-Inclusive Care for the Elderly (PACE) plan
You have the chance to join another employer or union coverage
You have or plan to enroll in other creditable drug coverage
You enrolled in a PACE plan
Changes to Your Current Plan’s Status with Medicare
Medicare takes a sanction against your plan
The state takes over your plan due to financial issues
Medicare terminates your plan’s contract, or your plan ends its contract with Medicare
Your plan’s contract with Medicare is not renewed
Other Special Situations and Exceptions
There may be additional special situations through which you qualify for a Special Enrollment Period. For a full list of examples, visit Medicare.gov. We can help simplify the Medicare process and make sure you understand the ins and outs of the Special Enrollment Period. There’s no obligation to enroll.
CMS SEP Guidelines 2026
Medicare SEP rules and qualifying events are updated annually by The Centers for Medicare & Medicaid Services (CMS), so it’s important to review the most current guidelines when making decisions. Always double-check that the Medicare plan information you’re using is up to date before enrolling in or changing a plan.
Your Medicare Special Enrollment Period Chart
Review some common acronyms you may need to know when navigating Medicare Special Enrollment Periods.
| Acronym | Full Term | Definition |
| SEP | Special Enrollment Period | A period during which individuals can enroll in or make changes to their Medicare coverage outside the standard enrollment periods. |
| SNP | Special Needs plan | A type of Medicare Advantage plan designed for people with specific diseases or characteristics, such as chronic conditions or disabilities. |
| MA | Medicare Advantage | A type of Medicare plan (known as Part C) that offers the same coverage as Original Medicare but through plans sold by Medicare-approved private insurers. |
| PDP | Prescription Drug plan | A standalone plan that provides prescription drug coverage under Medicare Part D. |
| MAPD | Medicare Advantage Prescription Drug plan | A Medicare Advantage Plan that includes prescription drug coverage (Part D). |
| QMB | Qualified Medicare Beneficiary | A Medicaid program for individuals who are eligible for both Medicare and Medicaid. |
| SLMB | Specified Low-Income Medicare Beneficiary | A Medicaid program that helps pay for Part B premiums for people who have limited income and resources. |
| LIS | Low-Income Subsidy | A program that helps pay for Medicare prescription drug costs for individuals with limited income and resources. |
| IRMAA | Income-Related Monthly Adjustment Amount | An additional premium amount that higher-income individuals pay for Part B and Part D coverage. |
| PACE | Program of All-Inclusive Care for the Elderly | A Medicare and Medicaid program that provides comprehensive health care for elderly individuals who are eligible for both programs. |
Navigating Specific Medicare SEPs
Understanding which SEP applies to your situation can be complex—but that’s where SelectQuote can help guide you through each step.
Working Past 65 SEP (Original Medicare)
If you delayed enrollment in Medicare Parts A and B because you or your spouse worked after turning 65 and are losing your group coverage, you typically qualify for a Special Enrollment Period for Original Medicare. You’ll be given a Special Enrollment Period of eight months to sign up, starting the month that follows the end of your employer coverage.
Unlike your Initial Enrollment Period, which is triggered by your 65th birthday, this Special Enrollment Period is triggered by a specific life event—making timing and documentation especially important.
Medicare Advantage and Part D SEPs
During a Special Enrollment Period, you may be able to enroll in a Medicare Advantage plan or a Prescription Drug (Part D) plan. In most cases, you’ll have two months to enroll after your qualifying event.
Additionally, there’s a Medicare Advantage SEP for individuals who are dual-eligible or who receive Extra Help. If you qualify, you may be able to make changes once per quarter during the first three quarters of the year.
Understanding Medicare SEP Hierarchy
Key Advice: Multiple Special Enrollment Periods can sometimes overlap. For example, if you’re losing employer coverage while also qualifying for Extra Help. Each SEP may have different timelines and rules, making it difficult to determine which one takes precedence. Working with a licensed Medicare professional, like a SelectQuote agent, can help you navigate these complexities and avoid missing critical deadlines.
How to Compare Plans During Your Medicare SEP
Because Special Enrollment Periods are tied to specific life events, they often come with strict deadlines—especially the short two-month window for Medicare Advantage and Part D plans. Missing your window could lead to delays in coverage or increased costs.
That’s where SelectQuote provides a key advantage. Instead of researching plans one by one on your own, you can work with a licensed insurance agent who compares multiple carriers at once, helping you quickly identify options that fit your needs, budget, and timeline. Our unbiased guidance focuses on what you need—so your plan choice feels clear and confident.
For information on the other types of Medicare Enrollment Periods, click on the links below:
Special Enrollment Period FAQs
What does the Dual/LIS SEP allow beneficiaries to do?
This monthly SEP allows beneficiaries to:
Switch from a Medicare Advantage plan with prescription drug coverage to Original Medicare and enroll in a standalone Prescription Drug plan (PDP)
Change between standalone PDPs
What is the Integrated Care SEP?
This monthly SEP enables full-benefit dually eligible individuals to:
Enroll in or switch between integrated Dual-Eligible Special Needs plans (D-SNPs) aligned with Medicaid-managed care organizations
Ensure coordinated coverage between Medicare and Medicaid services
What is the eight-month SEP for Medicare Part B?
The eight-month Special Enrollment Period (SEP) for Medicare Part B allows individuals who were covered by a group health plan based on current employment to enroll in Part B without a late enrollment penalty within eight months of losing that coverage.
Who qualifies for Medicare Special Needs plans (SNPs)?
A Medicare Special Needs plan (SNP) is designed to provide more focused care for individuals with specific health or financial needs. You may qualify if:
You have Medicare Part A and Part B
You live in the plan’s service area
You meet eligibility for one of the three SNP types: Dual-Eligible (D-SNP), Chronic Condition (C-SNP), or Institutional (I-SNP)
Better Understand Your Medicare Plan Options With SelectQuote
SelectQuote is here to help you understand Medicare Special Enrollment Periods and the available Medicare plans in your area. We can walk you through the process step by step and help you find the option that’s right for your needs. The process is free, and there is no obligation to enroll.
SelectQuote Senior Insurance Services is a division of SelectQuote Insurance Services. © 2026 SelectQuote Senior Insurance Services. All rights reserved.
Please see the Disclosures Page for more information.
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