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Medicare Special Enrollment Periods and You

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Life is not always as orderly a chain of events as we would like. Your life can change at a moment’s notice, and your situation can change drastically; you need your medical coverage to change with you. Medicare has special enrollment periods that allow its members to change the details of their coverage when major changes to their lives occur. While knowing these special periods can only help, you should always talk to a specialist first; they will be able to better guide you through the process and determine which special enrollment periods apply to you.

Special Enrollment Periods and You

Generally, once you have enrolled in Medicare, you can only make changes in your plan during a specific window of time depending on your last name; you must make any changes within that window. However, there is a range of circumstances that Medicare recognizes have a major effect on the life of its members, so it allows changes to their plans when those circumstances show up. By knowing about those situations, Medicare members can better manage their care and ensure they get the best coverage.

To take the best possible advantage of those periods, make sure you know your current plan and what changes you want to make to it. You can use to learn more about how to find a plan. Also, look at how the changes affect how you pay for Medicare; if that has changed, you may qualify for assistance. Lastly, ensure that you have all relevant paperwork available when you contact Medicare; the specialist you talk to can help walk you through all of the necessary issues when they know your specific needs. Make sure that you can communicate your needs, and you will be able to get the best possible care.

Changing Locations

Moving to a new location can be a major change and change the details of your plan, possibly even being the reason you need coverage in and of itself. Generally, you have two months to notify Medicare of a significant address change; if you are placed in some sort of institution, then you can notify Medicare during your stay and up to two months afterward. These changes include 

  • moving to an area without coverage or with a different type of coverage, 
  • returning to the country after spending time abroad 
  • being released from jail or placed into an institution.

Different Coverage

If your coverage changes or you receive a chance for different coverage, you need to contact Medicare. If you have a chance to drop Medicare because the plan you are opting into is as good or better than Medicare, then you can drop Medicare immediately; be advised that you may need to change doctors and pharmacies, however. Or if you merely want to change your plan, you have from December 8th to the end of February to make the change. However, if Medicare initiates the change, you have as long as two months to make changes, depending on the situation.

Other Situations

A wide variety of situations can be covered by special enrollment periods. However, they generally fall under one of two situations: You have other options for Medicare that happen over the year, or you changed your plans based on erroneous information. In general, if you are looking at a different form of governmental assistance or supplementary assistance, you can change once per the period of January to March, April to June, and July to September; you can change once per each period. Of course, everyone can make changes during December for the next year.

You can also make changes in your plan if you base your changes on erroneous information given to you and have supporting evidence of that. The most obvious are when you sign up for a company or union plan and find out the plan is not all it was promised. You can also be told the wrong things by a federal employee and make your decisions based on information from that employee. If that is the case, you have two months to make any necessary changes once you find out about the situation.

However, make sure that you have all of the necessary evidence. This may not be a major problem in some situations, but it never hurts to have as much information as possible; it is always better to have more evidence than needed than not enough.

Things To Keep In Mind When Changing Your Plan

First, make sure that you identify both you and your current plan; Medicare cannot go forward if it does not know who and what it is dealing with. Always ensure you have the information necessary to show that you deserve the special enrollment period; in most cases, this is pretty simple, but it can get involved in some cases. Also, make you know what changes need to be made; this helps expedite the situation.

As usual, it can only help to have the advice of a specialist. Suppose you encounter something that drastically changes your life. In that case, you should get in touch with Medicare as quickly as possible to deal with the situation as expediently as possible. Several issues can affect your Medicare enrollment for good or ill, and it is ultimately incumbent on you to keep Medicare informed of anything that may affect your enrollment. If something happens and you are unsure how it will affect your enrollment, contact Medicare as soon as possible so a specialist can talk you through it.             

Featured Photo by Hush Naidoo Jade Photography on Unsplash