Medicare Special Enrollment

If you are institutionalized, meaning you move into, reside in or move out of a qualified institutional facility like a skilled nursing facility, nursing home, but not an assisted living facility. Once you move to or reside in a qualified institution you can enroll or disenroll from a Medicare private health or drug plan once a month. After you move out of the facility you have tow months to enroll or disenroll form a Medicare private health plan or drug plane or to switch to another plan including original Medicare if you are in a Medicare Advantage plan. Your new coverage would start the first day of the month after you submit a completed application but not before you become institutionalized or qualify to enroll in a Special Needs Plan for institutionalized people.
Another example of an event that would trigger a SEP is when you become approved for Medicaid. You will get an SEP to join, disenroll from or switch Medicare private health or drug plans beginning the month you become eligible for Medicaid. Additionally if you lose Medicaid you have one SEP to switch your Medicaid private health or drug plan that begins the month you’re notified that you will lose Medicaid benefits and continues for two months after.
There are many other examples of events that would trigger Special Enrollment Periods and details can be found on or the CMS website. 


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