Medicare special enrollment period

Medicare special enrollment period

If you have a client that needs a Medicare plan outside their IEP, you need a Medicare special enrollment period to get them the coverage they need.  In this post, we go over the different special enrollment periods and how clients qualify.

Understanding Medicare Special Enrollment Periods

Medicare Special Enrollment Periods are designated times outside of the IEP (Initial Enrollment Period) or the AEP (Annual Enrollment Period) when individuals can make changes to their Medicare coverage. These periods are only allowed under specific circumstances.  The SEP provides an opportunity for individuals to enroll in a Medicare plan or change their existing coverage.

Watch a YouTube video on SEPs

Qualifying Events for SEPs

There are several life events that provide Medicare beneficiaries an opportunity for a Special Enrollment Period. We have listed some of the more common events that qualifying for an SEP below.

Moving

If a beneficiary moves to a new location that isn’t served by their current Medicare plan, they are eligible for an SEP.

Losing employer coverage

When an employee or their spouse loses their existing employer-sponsored health coverage, they qualify for a SEP to enroll in Medicare.

Qualifying for Extra Help

If a beneficiary qualifies for either their state’s  Extra Help program or Medicaid, they qualify for an SEP and have the ability to change their plan as much as 1 time per quarter for the first 3 quarters of each year.

Click here to view more SEP details

Maximizing Special Enrollment Periods

If your client qualifies for a Special Enrollment Period, it’s essential to act promptly to make sure they get the coverage they need within the time limits for the SEP. Here’s what you need to know to use the SEPs:

Know the deadlines

Each Special Enrollment Period has a specific deadline, so be sure to understand when the enrollment window opens and closes.

Review all plan options

Agents should take the time to review their client’s Medicare coverage options carefully. Consider factors such as premiums, deductibles, copays, network of providers as well as prescription drug coverage (when applicable) to find the plan that best fits their personal needs.

We provide many benefits to all our agents, including free quoting & enrollment tools.  These quote engines make it easy to look at the top plans side by side for your clients review.

Learn about Connecture & Sunfire

Explore Additional Benefits

Medicare Advantage plans offer additional benefits beyond Original Medicare, such as dental, vision, otc benefits, and much more. Show the client a side by side comparison of the top plans and see e which one fits their needs.

Stay Informed

Keep yourself informed about changes to Medicare rules and regulations, as well as any updates to coverage options. Staying informed helps agents remain compliant and provide the best advice to their clients.

Find out about SEPs for Emergencies or Disasters

Medicare Special Enrollment Periods are valuable opportunities for individuals to changes their coverage outside of typical enrollment periods. By understanding who qualifies for a Special Enrollment Period and how to use it, you ensure that clients have the coverage they need.

It is important to review all the options available to your clients and be sure they make an informed decision.  Click here to learn why you should contract with multiple Medicare carriers.