Special Election Period (SEP) circumstances

• You receive Extra Help (the low-cost Part D prescription drug program for people with incomes under a certain level). 

• You enter or leave a nursing home or other long-term care facility. 

• You lose coverage from Medicaid or a state program that pays your Medicare premiums.

• You switch to a Medicare Advantage plan that has earned Medicare’s highest quality rating (5 stars) if there is one in your area (you can switch any time of the year except for the first week of December).

• You move out of the plan’s service area.

• The plan withdraws service from your area, leaves Medicare entirely, or closes down.

• Medicare agrees with your complaint that the plan violated its contract with you, or that you were misled into joining the plan through fraud or erroneous or incomplete information.

• Medicare agrees that a federal employee made a mistake when processing your enrollment in this plan.

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