What is a Medicare SEP?

February 16, 2023

Those 65 and over, as well as those with specific disabilities and medical conditions, are covered by the federal health insurance program known as Medicare. The Annual Enrollment Period (AEP) and Special Enrollment Periods are two of the enrollment periods that Medicare allows for people to enroll in or modify their coverage (SEPs). This blog post will concentrate on SEPs and how they operate.

What is a Medicare SEP?

An individual who is already enrolled in Medicare may modify their coverage outside of the Annual Enrollment Period (AEP) during a Special Enrollment Period (SEP). A move to a new state or a declared local emergency is just two examples of the types of life events that SEPs are made to accommodate. SEPs come in a variety of forms, each with its own set of guidelines and qualifying standards.

How Do SEPs Function?

Depending on the particular type of SEP, different restrictions apply to that SEP. While some SEPs are triggered by life events, others are accessible to everyone who meets certain requirements.

Special Enrollment Period for Dual Eligible Individuals

If you are eligible for both Medicare and Medicaid, you may be eligible for a Special Enrollment Period. This SEP allows you to enroll in a Medicare Advantage plan or make changes to your existing coverage once per quarter during the first nine months of the year.

Special Enrollment Period for Losing Employer Coverage

If you lose your employer-sponsored health insurance, you may be eligible for a SEP. You have a SEP to enroll in Medicare Part B and/or a Medicare Advantage plan after losing your employer coverage.

Options Available

Pinnacle Financial Services is a full-service “FMO” that offers you the best technology in the business while giving you options as well. We are the only FMO in the country that offers both electronic enrollment platforms: Connecture and Sunfire. When you are contracted, certified, and ready to sell; both platforms are free of charge for our agents. You will be then able to utilize our tools to check out and then enroll your Medicare beneficiary. You will be able to narrow it down to the best Medicare advantage plan for your client with the extra benefits that fit their needs for them. There are no sales quotas or commitments that you need to make to us as we just want to help you grow your business.

Pinnacle has some of the best opportunities to help agents grow as well as receive individualized attention. The Pinnacle Medicare team is always available to assist should you give us a call.  If you’re interested in additional information, don’t hesitate in contacting your sales director for more.

For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Jessica Strauss

Jessica Strauss

Director of Sales - Health

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881


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