Definition. A Special Enrollment Period (SEP) lets you sign up for or change Medicare coverage outside the usual enrollment windows when certain things happen, such as losing job-based coverage, moving, qualifying for OHP or Extra Help, your plan leaving your area, or a declared emergency or disaster.
What it means
Common SEPs:
- Losing job-based coverage from your own or your spouse's current work: eight months to sign up for Part B without a penalty, and two months after the coverage ends to join a Medicare Advantage or Part D plan.
- Moving out of your plan's service area, or to an area with new plan options.
- Medicaid (OHP) or Extra Help: you can switch to a stand-alone Part D plan once a month; full-benefit dual eligibles can join an integrated dual special needs plan any month.
- Your plan ends or leaves your area: you can choose a new plan, and you also get a Medigap guaranteed-issue right.
- Emergencies and disasters declared by a federal, state or local government (42 CFR 422.62(b)(18)), if the disaster kept you from making a change.
- A 5-star plan: once a year, from December 8 to November 30, you can join a plan CMS rates 5 stars, if one is offered where you live.
In Oregon
Several companies stop offering Medicare Advantage plans in some Oregon counties for 2027. If your plan isn't renewing, you have an SEP through February 28, 2027; choose by December 31, 2026 to avoid a gap. See plans ending in 2027. Disaster SEPs follow declarations such as FEMA's for the September 2020 wildfires (DR-4562) and the 2024 eastern Oregon wildfires (DR-4854); state declarations count too. Read the wildfire SEP guide.
Sources
- Medicare.gov — Special Enrollment Periods
- 42 CFR 422.62 — Election of coverage under an MA plan
- FEMA — Oregon Wildfires and Straight-line Winds (DR-4562)
- FEMA — Oregon Wildfires (DR-4854)
Frequently asked questions
How long do I have to use an SEP?
It depends on the event. The Part B SEP after job-based coverage ends lasts eight months. Most Medicare Advantage and Part D SEPs last two months after the event. A plan non-renewal SEP for 2027 runs through February 28, 2027.
Is there an SEP after an Oregon wildfire?
There can be. Federal rules give an SEP to people affected by an emergency or major disaster declared by a federal, state or local government, if the disaster kept them from making a change they were eligible to make.
I have OHP or Extra Help. Can I change plans during the year?
Yes. People with Medicaid or Extra Help can switch to a stand-alone Part D plan once a month, and full-benefit dual eligibles can join an integrated dual special needs plan in any month.
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