Special Enrollment Period

What is a Special Enrollment Period?

Understanding the different enrollment periods is essential to avoid late enrollment penalties. But what if you qualify for a Special Enrollment Period? How does that work, and are penalties involved?

What is the Special Enrollment Period?

Special Enrollment Periods are available for people with circumstances that allow them to enroll outside of their Initial Enrollment Period. If you are still working at 65 and covered by health insurance through your employer (provided they have at least 20 employees), you can delay enrolling in Part B. Once you are no longer employed or lose the health coverage, you have eight months to enroll in Medicare. 

Special Enrollment Periods are also available if you experience an abrupt change in coverage from moving out of your plan’s service area or losing your current plan’s coverage. You may have to change coverage if you get married, have a baby, or adopt a child. For these events, you have 60 days around the event to enroll in a new coverage plan. If you fail to enroll during your Special Enrollment Period, you may have to wait until the next Open Enrollment Period.

Penalties

With a Special Enrollment Period, there is a good chance you will avoid paying late enrollment penalties. This is because the situation you are in excuses you from having to enroll in Medicare during the expected Initial Enrollment Period. However, if you were to miss your enrollment periods, you could be subjected to penalties that you will have to pay for the remainder of the time you have Medicare coverage.

What if I’m turned down?

If you are told you do not qualify for a Special Enrollment Period, but you disagree with the decision, you can file an appeal. You will have 90 days from the date you receive your eligibility notice to file. However, if you miss the 90 days, you may qualify for a “good cause” extension.

Temmen Insurance will help you!

If you are looking to enroll in a Medicare plan, don’t do it alone. Temmen Insurance will guide you through the Medicare enrollment process to avoid any confusion along the way!

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