Medicare Life-Event Playbooks
30 step-by-step playbooks for every major Medicare and senior-care life event.
What to Do When You Turn 65
Your 7-month Initial Enrollment Period starts 3 months before you turn 65 and ends 3 months after. Enroll in the first 3 months to avoid cov…
Retiring at 62 — What About Medicare?
Medicare eligibility starts at 65, not 62. If you retire at 62, you need bridge coverage (ACA Marketplace, COBRA, spouse's plan) until 65.…
Retiring at 65 With Employer Coverage
If you're still working at 65 with creditable employer coverage (20+ employee group), you can delay Part B without penalty. You get an 8-mon…
Retiring at 70 After Working Past 65
If you worked past 65 with employer coverage, your Special Enrollment Period begins when employment or coverage ends — whichever is earlier.…
Losing Employer Health Coverage
When active employment coverage ends, you have an 8-month Special Enrollment Period for Medicare Part B with no late penalty. You also get a…
Losing Medicaid Coverage
Losing Medicaid coverage triggers a 3-month Special Enrollment Period for Medicare Part B, Part D, or Medicare Advantage.…
Moving to a New State
Moving to a new state gives you a Special Enrollment Period to change Medicare Advantage plans or drop MA for Original Medicare. SEP lasts 2…
Losing a Spouse
Losing a spouse creates emotional and administrative urgency. Update Medicare/Social Security records, check spousal survivor benefits, and …
Medicare After Divorce
Divorce can affect Medicare eligibility and Medigap pricing but does not usually create a special enrollment right. Review any spousal-tied …
Becoming Newly Eligible for Medicaid
Newly gaining Medicaid eligibility triggers automatic Extra Help for Part D and possibly a D-SNP option. You also get a Special Enrollment P…
Moving Into a Nursing Home
Moving into a nursing home triggers an ongoing Special Enrollment Period to switch MA or Part D plans and may trigger Medicaid LTC eligibili…
Moving Out of a Nursing Home
Leaving a nursing home triggers a 2-month Special Enrollment Period to change MA or Part D plans.…
Becoming Disabled Under 65
After 24 months of Social Security Disability Insurance (SSDI) entitlement, you automatically receive Medicare. ALS and ESRD provide immedia…
ESRD Diagnosis at Any Age
An ESRD (kidney failure) diagnosis grants Medicare eligibility at any age. Coverage typically begins the first of the 4th month of dialysis,…
ALS Diagnosis
An ALS (Lou Gehrig's) diagnosis grants immediate Medicare eligibility upon SSDI approval — no 24-month waiting period.…
Retiree Health Coverage Ending
If a former employer ends retiree health coverage, you get a 63-day Medigap guaranteed-issue right for certain plans (C, D, F, G, K, L) if y…
Turning 26 on a Parent's ACA Plan
Age 26 is an ACA aging-out event. You have 60 days before or after your 26th birthday to enroll in a new ACA plan or other coverage.…
Qualifying for Extra Help (LIS)
Newly qualifying for Extra Help triggers a Special Enrollment Period to change Part D plans. Extra Help pays premiums, deductibles, and caps…
Your Plan Terminates or Changes Service Area
If your Medicare Advantage or Part D plan stops offering coverage or leaves your service area, you get a Special Enrollment Period to choose…
Returning to the US After Living Abroad
If you dropped Medicare while living abroad and return, you can use the General Enrollment Period (Jan 1 – Mar 31) with penalties, or a Spec…
Getting Married (Or Remarried)
Marriage doesn't create a Medicare SEP directly, but it can affect Medigap household discounts, spousal SS benefits, and IRMAA bracket (join…
COBRA Ending
When COBRA ends, you face a 63-day Medigap guaranteed-issue right and a 2-month Part D SEP. COBRA is NOT creditable for Part B — if you dela…
Your Plan's Star Rating Drops
If your MA plan's star rating drops below 3, CMS may offer a mid-year disenrollment SEP. Low-performing plans are rare but it's worth monito…
A 5-Star Plan Becomes Available
You can switch to a 5-star Medicare Advantage or Part D plan once per year, any time between December 8 and November 30, using the 5-Star SE…
Receiving a Cancer Diagnosis
A cancer diagnosis doesn't trigger a Medicare SEP but may make it critical to review your plan: in-network oncologists, prior authorization …
Receiving a Dementia Diagnosis
A dementia diagnosis is a pivotal moment for long-term care planning. Establish legal documents early, evaluate coverage, and project long-t…
Adult Child Starting to Caregive
Taking on caregiving for an aging parent touches many Medicare and legal issues. Establish power of attorney, understand Medicare coverage, …
Aging Parent Moves in With You
When a parent moves in, consider home modifications, caregiver services, Medicaid HCBS waivers, and tax dependency rules.…
Activating Long-Term Care Insurance
LTC insurance claims require documentation of dependency (inability to perform 2+ ADLs) or cognitive impairment. Approval may take 30–90 day…
End-of-Life Planning
End-of-life planning includes advance directives, hospice election, and estate planning. Medicare covers hospice at $0 for terminal prognosi…