By Christina Finkle
There are 20 Special Election Periods when you may change your plan. I am going to review the most applicable and common.
1. You, through no fault of your own, lose drug coverage that is at least as good as or better than Medicare’s (creditable) or your drug coverage is reduced so that it is no longer creditable. (This does not include losing your drug coverage because you do not pay, or cannot afford, your premiums.)
2. You choose to change employer/union coverage (through either current or past employment).
3. You are institutionalized (skilled nursing facility, nursing home, psychiatric hospital etc.).
4. You are enrolled in a State Pharmaceutical Assistance Program (SPAP) such as EPIC.
5. You have Extra Help, Medicaid, or a Medicare Savings Program (MSP), or you gain, lose, or have a change in your Medicaid, MSP, or Extra Help eligibility status.
6. You want to disenroll from your first Medicare Advantage Plan (First Year Medicare Trial Period).
7. You enroll in/disenroll from PACE (Program of All-Inclusive Care for the Elderly).
8. You move (permanently change your home address) out of your current plan’s service area. Change of address must be on file with Social Security.
9. You are eligible for a Special Needs Plan (SNP) or lose eligibility for your SNP.
10. You are enrolled into a Part D plan or Dual-eligible SNP (D-SNP). Dual-eligible means you have BOTH Medicare and MEDICAID.
11. You qualify for a new Part D Initial Enrollment Period when you turn 65.
Each of these Special Election periods have a certain time frame associated in which you can utilize the election to change your plan. Some may only be 30 days, 2 months, etc.
Please make sure you are aware of the allowable time frame based on your special election period. Feel free to email questions regarding your particular circumstances to firstname.lastname@example.org.