Special Enrollment Periods (SEPs) are periods of time outside normal enrollment periods where you can enroll in health insurance. They are typically triggered by specific circumstances.
The Part B SEP is a period of time when you can enroll in Medicare Part B after your initial enrollment period. You can use the Part B SEP while you are covered due to current work and for 8 months after you no longer have coverage from current work (job-based insurance). Using the Part B SEP also means you will not have to pay a Part B late enrollment penalty (LEP) (see Does Part B Have a Late Enrollment Penalty?). If you are considering delaying Part B enrollment because you have job-based insurance, make sure to also learn whether your coverage will be primary or secondary.
To use the Part B SEP, you must meet two criteria:
- You must have insurance from current work (from your job, your spouse’s job, or sometimes a family member’s job) or have had such insurance within the past eight months.
- And, you must have been continuously covered by job-based insurance or Medicare Part B since becoming eligible for Medicare, including the first month you became eligible for Medicare.
Note: You can have no more than eight consecutive months without coverage from either Medicare or insurance from current work. You are ineligible for the Part B SEP after going for more than eight months without Part B or job-based insurance.
In most cases, you should enroll in Medicare immediately after losing job-based insurance to avoid gaps in coverage, even though your SEP may last for several more months. Remember, even if you use the SEP to avoid a late enrollment penalty, you may still be responsible for any health care costs you incur in the months after losing job-based coverage, or after your coverage becomes secondary, before your Medicare coverage takes effect.
If you plan to delay enrollment into Part B and use the SEP later, keep records of your health insurance coverage. You will be required to submit proof of your enrollment in job-based insurance when accessing the SEP. Proof of enrollment in job-based insurance includes:
- Written notice from your employer or plan.
- Documents that show health insurance premiums paid, including W-2s, pay stubs, tax returns, and/or receipts.
- Health insurance cards with the appropriate effective date.
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