A client can't enroll or switch plans whenever they feel like it — timing is one of the most compliance-sensitive parts of the entire call. Two windows repeat every calendar year; two more depend on the individual.
| Period | Who | Window |
|---|---|---|
| IEP (Initial) | Anyone newly eligible for Medicare | 7 months total: 3 before, the month of, and 3 after their 65th birthday month |
| AEP (Annual) | Everyone on Medicare | Oct 15 – Dec 7, every year, effective the following Jan 1 |
| MA OEP (Open) | Only current Medicare Advantage members | Jan 1 – Mar 31, one plan switch allowed |
| SEP (Special) | Triggered by a qualifying life event | Varies by event — e.g. moving, losing employer coverage, a 5-star plan switch, or a documented income/eligibility change |
| Dual/LIS SEP | Dual-eligible or LIS-only clients | Any month — but only to switch a standalone Part D plan |
| Integrated Care SEP | Full-benefit dual-eligible clients | Any month — but only into an integrated D-SNP aligned with their Medicaid plan |
| Disaster/Emergency SEP | Anyone in a FEMA or state-declared disaster area (or affected by one) during a valid election period they missed | Usually opens for the length of the declared incident period, plus extra time after — verify the exact window on PEAK's DST list before relying on it |
The SEP most new agents miss: disaster & emergency declarations
CMS grants a Special Enrollment Period to anyone who lives in — or had a trusted contact (agent, family member, plan) in — an area under a FEMA or state emergency/major disaster declaration, if that disaster kept them from making an enrollment change during a valid window they otherwise qualified for (like AEP, an SEP, or their IEP). This comes up more often than agents expect: hurricanes, wildfires, floods, and severe winter storms all trigger it, and Florida clients are affected almost every hurricane season.
The disaster SEP is county-specific and time-limited — it only applies to the counties named in the declaration, and only for a defined window tied to the incident period. It is never safe to assume a client qualifies just because they mention a storm; the county and the dates both have to check out.
Check the DST list before you promise a disaster SEP
If a client mentions a recent hurricane, wildfire, flood, evacuation, or any other disaster — or you're not sure whether their county currently qualifies — look it up on PEAK's live Disaster SEP Tracker before you tell them anything. It's the fastest way to confirm the exact counties, dates, and incident covered.
Open the Disaster SEP Tracker on peaksep.com →When to check peaksep.com, in general
The DST list isn't only for disasters — it's PEAK's go-to hub for verifying SEP eligibility whenever timing is anything other than a clean AEP or IEP call. Get in the habit of checking it whenever you hear one of these:
- Recent move — new address, especially if it's a new county or out of the plan's service area.
- Lost employer or group coverage — retirement, layoff, COBRA running out, or the employer dropping the plan.
- Hospital or nursing home discharge — leaving an institution changes eligibility and can open a SEP.
- Natural disaster or evacuation — hurricane, wildfire, flood, or any declared emergency, even outside their own county.
- 5-star plan availability — a 5-star MA or Part D plan is available in their area, opening a one-time-per-year SEP.
- Medicaid or LIS status change — newly qualifying for, or losing, Medicaid or Low-Income Subsidy.
- Dual-eligible status change — becoming or ceasing to be dual-eligible, which changes which SEPs apply.
If you're ever unsure whether a situation qualifies, the safest move is the same one every time: check peaksep.com or ask a manager before telling the client anything is confirmed.
Quick check