Medicare Answers: SEP for Client on Disability

  • Originally published August 7, 2012 , last updated December 23, 2014
  • Medicare
Medicare Answers: SEP for Client on Disability

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This week’s question asks when a client who has been on Disability and is now eligible for Medicare can enroll in a Medicare Advantage plan.

Vic asks,

If someone was on SS DI for 24 months and had a Medicare effective date of August 1, 2012, what is their SEP? Is it three months before, the month of their effective date and three months after? Is it something different?

Your client has been disabled for 24 months and now is eligible for Medicare Part B. You want to know when their Special Election Period (SEP) begins for Medicare Advantage. Here is what Medicare says: The client can sign up for a Medicare Advantage and/or Prescription Drug plan any time during the 7-month period that starts 3 months before their 25th month of disability and ends 3 months after their 25th month of disability.

If the client was already on Medicare due to a disability and was now turning 65 their SEP would be the 7-month period that starts 3 months before the month they turn 65, the month they turn 65 and the 3 months after the month they turn 65. During this time they are eligible to sign up for an MA and/or PDP plan, switch to another MA and/or PDP plan or drop an MA and/or PDP plan completely.

To learn more about Medicare enrollment periods, download this tip sheet from Medicare.