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Active SEPs
Click here to view a list of active Special Enrollment Periods.
Check back periodically for an updated list.
Updated 10/15/24: Based on the recently released final rule document, CMS has extended the length of SEPs that are based on Federal, State, or Local Emergency/Disaster Declarations. For Individuals who did not enroll in Medicare Part B or premium part A when first eligible will have until six months after the end of the incident period to enroll. Fill out CMS -10797 and send the completed form to your local social security via mail or fax to avoid a late enrollment period. For clients currently enrolled in Medicare Advantage/PDP, the DST SEP is still available to individuals who missed a valid election period to enroll or make changes to their plan until two months after the end of the incident period. This update applies to all declarations made after January 1, 2023.
Breakdown of SEP Codes
For a complete breakdown and info about each SEP code, click here.
| Code | Language | Timeline | Special Notes |
| IEP | This is the first time I am enrolling in Medicare | Three months before, the month of, and three months after the 65th birthday or eligibility due to 24 months of Social Security Disability Benefits | The consumer may make one election. If the consumer is in an active plan that has effectuated, the IEP has ended and is no longer a valid election. |
| IEP2 | I became eligible for Medicare before age 65 due to disability, but am turning 65 | Three months before, the month of, and three months after the 65th birthday | |
| ICEP | Delayed Part B while already has Part A | Three months before Part B begins, ends the last day of the month before Part B effectuates | If Part B has effectuated, the SEP is over. It’s possible the delay in starting Part B was due to remaining with employer coverage until retirement. |
| LEC | Loss of employer or union coverage (includes COBRA) | The month of and two months after loss. | May coincide with Delayed Part B |
| MDE(LIS) | Individuals who receive assistance from Low Income Subsidy (LIS), a.k.a Extra Help that, have not yet made a change in this quarter. | Once per quarter Jan-Mar April-Jun July – Sept | If the election has been used and the policy has been effectuated, you must wait until the first day of the next quarter to submit. SEPT 30 IS THE LAST DAY TO USE THIS ELECTION FOR THE YEAR |
| NLS | I have had a loss, gain, or change in my level of Extra Help (LIS) | Three months from the time of change | Available for use after Sept 30 |
| MCD | I have had a loss, gain, or change in my level of Medicaid | Three months from the time of change | Available for use after Sept 30 |
| MOV | I have moved out of my service area, and my plan is no longer available, or new options have become available. | The month before the move, the month of the move, and two months after | Does not apply to moves across town, to a different zip code in the same service area, or a different city in the same service area. |
| 5ST | A 5-Star plan is available in my service area | Once per calendar year | |
| MDE(Medicaid) | Individuals who receive assistance from Medicaid that have not yet made a change in this quarter. | Once per quarter Jan-Mar April-Jun July – Sept | If the election has been used and the policy effectuated, you must wait until the 1st day of the next quarter. SEPT 30 IS THE LAST DAY TO USE THIS ELECTION EACH YEAR |
| PAP | I belong to a pharmacy assistance program provided by my state or losing/recently lost participation in such a program. | Once per calendar year while enrolled in the PAP or within two months of the loss | Check this website to see if the member may qualify for a PAP: https://www.medicare.gov/plan-compare/#/pharmaceutical-assistance-program/states?year=2024&lang=en |
| CHR | Those eligible for a C-SNP policy due to a diagnosed chronic health condition or those who were deemed ineligible (denied) for a C-SNP | Once per calendar year unless moving from one C-SNP type to another (Diabetes to Chronic Heart Condition) or two months from the date of denial notice | Must be for a C-SNP unless the consumer was previously denied. Documentation of that denial may be required for enrollment into a regular plan. |
| LCC | Involuntary Loss of Creditable Coverage | Two months from the time of loss | This does not apply if the consumer actively canceled coverage, or coverage was terminated due to non-payment of premium. |
| DST | I was unable to enroll previously due to a government-declared disaster | Within two months following the end date of the disaster. | MUST HAVE MISSED ANOTHER VALID ELECTION PERIOD DUE TO DISASTER. DISASTERS BY THEMSELVES ARE NOT SEPs COVID-19 NO LONGER VALID BY CMS STANDARDS |
| PAC | For individuals leaving a Program of All-Inclusive Care for the Elderly (PACE) | Two months after the date of PACE disenrollment | DO NOT PULL PEOPLE OUT OF PACE PLANS FOR MEDICARE ADVANTAGE |
| NON | My plan is ending its contract with Medicare | Only valid Dec 8 through the last day of Feb. | |
| SNP | Individuals who lost Special Needs status (D-SNP/I-SNP/C-SNP) | Three months from time, ineligibility is determined | |
| RUS | Recently returned to the U.S. after living permanently abroad | Within two months after the move | |
| OEPN | New Medicare beneficiary who enrolled in a Medicare Advantage plan during IEP/ICEP and would like to make a change. | The beneficiary is currently enrolled in an MA/MAPD within the first three (3) months of their Medicare entitlement and has not already used the OEP election. Check MARx to validate Medicare A and B or Medicare B. | Applies only to those with Medicare Advantage. Is not valid for those with only Original Medicare with/without a PDP/Medigap. |
| OCC | I would like to disenroll from either MAPD or PDP to enroll in an MA-only plan because I receive or will receive other creditable drug coverage, such as the VA. | One-time use or 2 months after disenrollment from a MAPD or PDP | APPLIES TO MA-ONLY DO NOT ENROLL TRICARE FOR LIFE BENEFICIARIES |
| DIF | Individuals enrolled in a plan by Medicare (or their state) and want to choose a different plan. | Within three months from the effective date of the government enrollment | These enrollments occur due to low-income status. The consumer may have Medicaid and/or Extra Help (LIS) Please see MARx to determine the effective date of government enrollment |
| PRE | Individuals who are not entitled to premium-free Part A and enroll in Part B during the Part B General Enrollment Period (GEP). (MAPD and PDP) | Month of and two months following active Part B | This is Part B GEP enrollment |
| LAW | I recently obtained lawful presence status in the United States | The month lawful presence starts, continues 2 additional months | |
| INC | I was recently released from incarceration | Within 2 months of the release date | |
| OEP-1 for MAPD LTC or PDP | Moving into, currently live in, or recently moved out of a Long-Term Care Facility | Unlimited use if currently living in Long Term Care Facility. One-time use within 2 months of leaving a facility. | This does not apply to assisted living facilities, residential homes, or short hospital stays |
D-SNP 2025 Map
