Two New Medicare Special Enrollment Periods Introduced in 2025

People with Medicare are given the opportunity to make changes to their coverage during specific times of the year. If you need to make a change or switch Medicare Advantage or Prescription Drug Plans, you can do so during enrollment periods. 

The annual Open Enrollment Period from October 15 through December 7 allows anyone with Medicare to switch, drop, or change their coverage. The Medicare Advantage (MA) Open Enrollment Period from January 1 through March 31 allows individuals with an MA plan to switch one time from one plan to another.  If you qualify, Special Enrollment Plans (SEPs) may be the only other chance you have to change your Medicare coverage. What is a Special Enrollment Period?Eligibility for Special Enrollment Periods is based on certain qualifying life events. For instance, if you move out of your current plan’s service area, move into an institution, or move back into the country after living abroad, you may qualify for an SEP.  You may also be eligible if you lose other creditable coverage through a union or employer, or qualify for a Medicare Advantage Special Needs Plan due to a diagnosis of a chronic condition or becoming dual-eligible for Medicare and Medicaid. The timing for your Special Enrollment Period may be based on your specific circumstances.Starting in January, 2025, two new special enrollment periods are being introduced for low-income individuals who qualify. New Monthly SEPIf you are dual-eligible for both Medicare and Medicaid, have Medicare and receive assistance from the Low-Income Subsidy, or qualify for partial-benefit dual eligibility, you may have access to a new Special Enrollment Periods starting in January 2025: The Monthly SEP.If you’re enrolled in a Medicare Advantage plan and meet the criteria mentioned, you will now have a Monthly SEP during which you can drop your Medicare Advantage plan and revert to Original Medicare. You’ll be allowed to enroll in a stand-alone Prescription Drug Plan at this time. You can use the Monthly SEP once per month and your new coverage will be effective on the first day of the following month. What is the Integrated Care SEP?Full-benefit dual-eligible individuals will have access to an Integrated Care Special Enrollment Period. Once per month, you’ll have the opportunity to switch to a fully-integrated Dual-eligible Special Needs Plan, a highly integrated Dual-eligible Special Needs Plan, or an applicable integrated plan. According to the Centers for Medicare & Medicaid Services (CMS), this SEP is to be used to align enrollment with an integrated Dual-eligible Special Needs Plan (D-SNP) and a Medicaid managed care organization.