What is the Special Election Period (SEP) for Dual Eligible and Other LIS Eligible Individuals replaced with beginning Calendar Year 2025?

The Special Election Period (SEP) for Dual Eligible and other Low-Income Subsidy (LIS) Eligible Individuals provides these beneficiaries with additional opportunities to enroll in or change their Medicare Advantage and prescription drug plans outside of the usual enrollment periods. Starting in Calendar Year 2025, this SEP is replaced with the Monthly SEP.

The Monthly SEP allows individuals to make changes to their Medicare coverage on a more frequent basis, specifically each month, thereby offering greater flexibility and ensuring that those who are dual eligible or receive LIS have better access to suitable healthcare coverage that meets their changing needs. This shift signals a move toward more consumer-friendly options for those who may require adjustments to their healthcare choices based on their financial or health circumstances.

Understanding this transition is crucial for ensuring that beneficiaries are aware of their options and can take advantage of the times they can change plans, which enhances their healthcare management. This is particularly important for vulnerable populations who may experience fluctuations in their health status or financial situations on a regular basis.