Frequently Asked Questions
What is a Medicare Special Enrollment Period?
A Special Enrollment Period (SEP) is a time outside the Annual Enrollment Period (AEP) when you can make specific changes to your Medicare coverage, triggered by qualifying life events. SEPs allow you to join, switch, or drop Medicare Advantage or Part D plans when specific circumstances change — such as moving, losing other coverage, or your plan leaving your area.
What qualifies for a Medicare Special Enrollment Period?
Qualifying events for a Medicare SEP include: moving to a new address outside your plan's service area, losing employer or union drug coverage, your Medicare Advantage or Part D plan leaving Medicare, gaining or losing Medicaid eligibility, qualifying for Extra Help (Low Income Subsidy), being released from incarceration, returning from living outside the US, and enrolling in or losing a PACE program.
How long is a Medicare Special Enrollment Period?
SEP lengths vary by trigger. Moving to a new address: 2 months from the month you notify your plan. Losing employer coverage: 2 months from loss of coverage. Plan leaving Medicare: 2 months before the plan ends. Qualifying for Extra Help: any time, year-round. Disenrollment from Medicare Advantage plan into Original Medicare: January 1–March 31 each year (Medicare Advantage Open Enrollment Period, or MA OEP).
Can I switch from Medicare Advantage to Original Medicare at any time?
During the Medicare Advantage Open Enrollment Period (January 1–March 31) — yes. You can switch from a Medicare Advantage plan to Original Medicare and join a standalone Part D plan. This window occurs every year and is separate from AEP. However, you cannot switch from Original Medicare to Medicare Advantage during MA OEP — only the reverse.
What is a 5-star Special Enrollment Period?
Medicare allows beneficiaries to switch to a Medicare Advantage or Part D plan with a 5-star CMS quality rating at any time during the year — once per year. This is called the 5-Star SEP. Not all plans achieve 5 stars — check Medicare.gov Plan Finder filter by star rating. If a 5-star plan is available in your area, you can enroll in it January 1 through November 30, with a 1-month delay before the change takes effect.
AEP (October 15–December 7) gets all the attention, but it's not your only opportunity to change Medicare coverage. Special Enrollment Periods create windows outside AEP whenever qualifying life events occur. Knowing your SEP rights means you're never trapped in a plan that no longer works for your situation.
Most Common SEP Triggers
Moving to a New Address
If you move to a new address outside your Medicare Advantage or Part D plan's service area, you qualify for a 2-month SEP to join a new plan in your new area. You must notify your current plan of your new address. This SEP begins the month you notify the plan and lasts 2 months. If you move within your plan's service area, this SEP does not apply — but your plan's network may have changed in your new location.
Losing Employer or Union Coverage
When you leave an employer plan that was your primary coverage, you have a 2-month SEP to join a Medicare Part D plan or Medicare Advantage plan. This is separate from the 8-month SEP for Part B enrollment. The 2-month window for drug coverage begins when your employer drug coverage ends — not when COBRA ends. If you use COBRA as a bridge, you are still in your 2-month SEP window from when employer coverage ended.
Your Plan Leaves Medicare
Medicare Advantage and Part D plans can exit Medicare at the end of each year. If your plan is discontinuing, you receive notice by October 1 and have a 2-month SEP before the plan ends to choose a new plan. This is your opportunity to find a plan with equivalent or better coverage without waiting for AEP timing.
Qualifying for Extra Help
Qualifying for Medicare Extra Help (Low Income Subsidy) for Part D gives you a year-round SEP to join or switch Part D plans at any time. This allows low-income seniors to optimize their drug coverage whenever they qualify — not just during AEP. If you gain or lose Medicaid or Medicare Savings Program status, you also get this ongoing SEP.
Medicare Advantage Open Enrollment Period (MA OEP)
January 1–March 31 every year — this is a separate enrollment window for people already in a Medicare Advantage plan. During MA OEP you can: switch to a different Medicare Advantage plan, or switch from Medicare Advantage to Original Medicare (and join a Part D plan). You cannot switch from Original Medicare to Medicare Advantage during MA OEP — that requires AEP or a qualifying SEP. Changes during MA OEP take effect the first of the month after your enrollment is processed.
5-Star SEP — Switch to Excellence Anytime
If a Medicare Advantage or Part D plan in your area has earned a 5-star CMS quality rating, you can switch to it at any time from January 1 through November 30 — once per year. The change takes effect the first of the following month. Five-star plans represent exceptional quality in care management, member services, and health outcomes. Check Medicare.gov Plan Finder and filter by star rating to see if a 5-star plan is available in your area.
How to Use a SEP
- Confirm your qualifying event and the SEP type it triggers
- Note your window — most SEPs are 2 months from the triggering event
- Use Medicare.gov Plan Finder or call 1-800-MEDICARE to find available plans
- Enroll in your new plan — the change typically takes effect the first of the following month
- If you have questions about whether your situation qualifies, call your State SHIP for free guidance
- Moving? You have 2 months from notifying your plan to switch to a new area plan
- Leaving employer coverage? Start your Part D plan within 2 months — not when COBRA ends
- Already in Medicare Advantage? January 1–March 31 you can switch to Original Medicare
- Qualify for Extra Help? You can change Part D plans year-round
- Check for 5-star plans in your area — you can switch to them any time Jan 1–Nov 30
→ AEP 2026 Action Plan — The Annual Window
→ Avoid Late Enrollment Penalties
→ Signs You Should Switch Plans