Apr 9, 2021

How to qualify for a Special Enrollment Period (SEP)

We’re hearing from many Rhode Islanders who were planning to work longer, but are now considering other options. As a quick refresher, prospects/clients may be able to enroll or make changes to their coverage if they:

  • Retired and left an employer or union plan
  • Moved out of their current plan’s service area
  • Moved into or out of an institution, such as a long-term care facility
  • Qualify or are no longer eligible for Medicaid

Quarterly SEPs—how do they work and who qualifies?

If your client qualifies for a low-income subsidy and/or Medicaid, they may be eligible for a quarterly SEP and can have ACCESS to even more benefits. They can join, switch, or drop their MA plan or Medicare prescription drug coverage one time each quarter from January through March, April through June, and then from July through September. If they make a change, it takes effect on the first day of the following month.

They can’t use this SEP from October–December. However, all people with Medicare can make changes to their coverage during AEP.

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