Understanding Medicare Part D special enrollment periods



Most everyone knows that when you are about to become eligible for Medicare, you should choose a Medicare approved drug plan.  What many people don’t know is that Medicare Part D enrollment is not limited to first becoming eligible for Medicare or taking advantage of the Annual Enrollment Period (AEP) that takes place each year between November 15th and December 31st.

As a Medicare beneficiary, you may be able to take advantage of a Special Enrollment Period (SEP), where you are able to change your Medicare Part D enrollment. The following list defines the SEP and details the changes that can be made.

You are eligible for both Medicare and Medicaid. Also know as being dual eligible, you are able to join, change or drop prescription drug coverage anytime.
You qualify for extra help paying for your Part D coverage. You have the right to join, change or drop prescription drug coverage anytime.
You are enrolled in a State Pharmaceutical Assistance Program. You can join a prescription drug plan once during the calendar year.
You dropped a Medicare supplement (Medigap) the first time you enrolled in a Medicare Advantage Plan. Within the first 12 months of being enrolled in the Advantage Plan, you can drop that plan, return to original Medicare and pursue Medicare Part D enrollment.
You have a severe or disabling condition and there is a Chronic Special needs Plan available for you condition. You can join a Chronic Special Needs Plan that will  include Part D prescription drug coverage. You can join anytime, but have lost your ability to make additional changes until your Annual Enrollment Period.
You no longer qualify for a Chronic Special Needs plan because you no longer have the qualifying health condition. You can switch plans, but only have 3 months from losing your Chronic Special Needs Plan to do so.

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