Medicare serves as a crucial lifeline for millions of individuals across the country, providing essential healthcare coverage for seniors and certain individuals with disabilities. While enrolling in Medicare is a milestone, life changes may necessitate adjustments to your plan outside of the typical enrollment periods. In this blog, we’ll explore Special Enrollment Periods (SEPs) and provide valuable insights on when and how to make changes to your Medicare plan. At Benefit Design Services, serving the tri-state area of West Virginia, Ohio, and Kentucky, we’re committed to helping you navigate the complexities of Medicare Advantage Plans and ensure you have the coverage that best meets your evolving needs.

Understanding Special Enrollment Periods:

Special Enrollment Periods (SEPs) are designated time frames outside of the Annual Enrollment Period (AEP) during which individuals can make changes to their Medicare coverage. These periods are triggered by specific qualifying events and provide an opportunity to enroll in, switch, or disenroll from certain Medicare plans.

Qualifying Events for SEPs:

Various life events can qualify you for a Special Enrollment Period, including:

  1. Moving to a new area not covered by your current Medicare plan.
  2. Losing your current healthcare coverage due to factors such as losing employer-sponsored coverage, Medicaid eligibility changes, or the termination of your current plan.
  3. Gaining new healthcare coverage, such as becoming eligible for Medicaid or obtaining coverage through an employer or union.
  4. Experiencing changes in your current Medicare plan, such as a plan no longer being offered or being notified of a plan contract termination.
  5. Eligibility for Extra Help with Medicare Prescription Drug Costs.

Making Changes During a Special Enrollment Period:

When you experience a qualifying event, it’s essential to act promptly to make changes to your Medicare coverage. Here’s how you can navigate the process:

  1. Gather Necessary Documentation: Collect any relevant documents, such as proof of your qualifying event or documentation of your new address, to support your request for a Special Enrollment Period.
  2. Contact Benefit Design Services: Reach out to our knowledgeable team at Benefit Design Services to discuss your situation and explore your options for adjusting your Medicare plan. We’ll guide you through the process and help you understand the implications of your choices.
  3. Review Available Plans: Take the time to review the Medicare Advantage Plans available in your area and compare their benefits, costs, and network coverage. Our team can provide personalized recommendations based on your unique healthcare needs and preferences.
  4. Enroll or Make Changes: Once you’ve selected a Medicare plan that meets your needs, we’ll assist you in completing the necessary enrollment or change request forms. We’ll ensure that your request is submitted accurately and in a timely manner to avoid any gaps in coverage.
  5. Stay Informed: Throughout the process, we’ll keep you informed of any updates or changes to your Medicare coverage. We’re here to answer any questions you may have and provide ongoing support to ensure a seamless transition.


Special Enrollment Periods offer valuable opportunities for individuals to adjust their Medicare coverage when life changes occur. Whether you’re relocating, experiencing a loss of coverage, or gaining new healthcare options, Benefit Design Services is here to help you navigate the complexities of Medicare and make informed decisions about your healthcare coverage. Don’t wait until the next Annual Enrollment Period – contact us today to explore your options and ensure you have the coverage you need to stay healthy and protected.