Medicare Special Election Periods
Medicare eligible members may be able to join or change Medicare Advantage plans under special circumstances that qualify as Special Election Periods (SEP).
A SEP provides the opportunity to enroll in or change plans, if your employee is:
- Enrolled in the Elderly Pharmaceutical Insurance Coverage (EPIC)
- Losing EPIC eligibility
- Losing Employer sponsored coverage
- Moving or moved out of a plan service area or to an area with expanded plan options
- Living in an institution (ie: skilled nursing facility, long term care hospital)
- Dual eligible (Medicare and Medicaid eligible)
- No longer Medicaid Eligible
- Approved for Low Income Subsidy (LIS)
- Involuntarily losing creditable drug coverage
- Qualified for other exceptional conditions as determined by CMS
Contact your account consultant with any questions.