Key Takeaways

  • There are Special Enrollment Periods (SEPs) that apply when eligible for delayed enrollment in Medicare Parts A, B, C, & D.

  • These SEPs are only available when specific events happen in your life, like if you lose employer-provided insurance coverage or move.

There are Special Enrollment Periods (SEPs) that apply when eligible for delayed enrollment in Medicare Parts A, B, C, & D. These SEPs are only available for certain circumstances. Learn more about Medicare Special Enrollment Periods.

When Is My Special Enrollment Period?

Special Enrollment for Parts A and B

You can delay enrollment in Medicare Part A (hospital service) and/or Part B (outpatient medical services) if you are employed at a company with more than 20 employees on your 65th birthday. You must also be enrolled in healthcare coverage through your employer, union, or spouse’s employer.

A Special Enrollment Period is offered to sign up for Parts A and/or B:

  • If you are still covered by a health plan through an employer, union, or spouse’s employer, OR
  • During the 8 months following the month the employer or union group health plan coverage ends, or when the employment ends (whichever is first).

You may incur a penalty if you choose to delay enrolling in Part A and/or Part B. Learn more about penalties. You may also incur a penalty if you are disabled and working or have health insurance coverage through a spouse or family member. Under these circumstances, you may be eligible to enroll in Part A and/or B under a Special Enrollment Period.

COBRA and retiree health plans aren't considered coverage based on current employment. You're not eligible for a Special Enrollment Period when that coverage ends. This Special Enrollment Period also doesn't apply to people who are eligible for Medicare based on having End-Stage Renal Disease (ESRD)

Special Enrollment Periods for Parts C and D

There are certain circumstances where you may be eligible to enroll in Part C and Part D under a Special Enrollment Period (SEP). For example, you may have delayed enrollment because you received health insurance coverage through your employer, union, or spouse's employer on your 65th birthday. The SEP for Part C (Medicare Advantage Plan) and Part D (drug coverage) is 63 days after the loss of employer healthcare coverage.

The Special Enrollment Period to sign up for Part C (must also be enrolled in Parts A & B) occurs:

  • During the 63 days after the employer or union group health plan coverage ends, or when the employment ends (whichever is first).

The Special Enrollment Period to sign up for Part D (must also enroll in Part A & B) occurs:

  • During the 63 days after employer/union or Veteran’s Administration coverage ends, or when the employment ends (whichever is first).

Certain events trigger other Special Enrollment Periods for Part D plans. For example, switching plans can occur if:

  • There is a move outside area current plan serves, OR
  • Entering or leaving a nursing home, OR
  • Plan changes and no longer serves the area, OR
  • Receiving Extra Help with Medicare prescription drug costs, OR
  • Enrolled or dropped from a State Pharmacy Assistance Program, OR
  • Your plan is sanctioned or terminated by Medicare. 

Medicare Advantage “Trial Period” Special Enrollment Period  

People who enroll in a Medicare Advantage plan when they are first eligible for Medicare Part A at age 65 get a “trial period” (up to 12 months) to try out Medicare Advantage. This SEP allows them to disenroll from their first Medicare Advantage plan and go to Original Medicare. At this time, they also get a “guaranteed issue right” to purchase a Medigap supplemental plan. Under federal law this right lasts for 63 days after disenrollment from the MA plan. (They also get a Special Enrollment Period to join a Part D plan.) Learn more at Medicare.gov