---
title: "Medicare Special Enrollment Periods: Every SEP Trigger Agents Must Know"
description: "SEPs are year-round selling opportunities most agents miss. Here are all 20+ qualifying events and how to prospect around them."
url: https://unlockedcrm.ai/blog/medicare-special-enrollment-periods-guide
canonical: https://unlockedcrm.ai/blog/medicare-special-enrollment-periods-guide
category: "Medicare"
published: 2026-10-13
author: "Jacob Lock"
source: unLocked CRM — AI CRM for insurance agents
---

# Medicare Special Enrollment Periods: Every SEP Trigger Agents Must Know

## TL;DR

20+ Medicare SEP triggers create year-round selling opportunities beyond AEP. High-volume triggers include moves, employer coverage loss, dual-eligible changes, and 5-star plan switches. Build referral networks with HR, real estate agents, and social workers.

## Key data points

- 20+ Medicare SEP triggers create year-round selling opportunities
- 5-star plan SEP allows switching December 8 – November 30 annually
- Dual-eligible SEP provides monthly enrollment opportunity with no waiting
- SEP prospecting through HR and real estate referrals generates consistent leads

# Medicare Special Enrollment Periods Guide

While most agents focus on AEP (October 15 – December 7), Special Enrollment Periods create year-round Medicare selling opportunities. Understanding every SEP trigger transforms a seasonal business into consistent monthly revenue.

## High-Volume SEP Triggers

**Moving to a new service area** — Client moves to an area where their current plan isn't available. 60-day window. Applies to MA and PDP plans.

**Losing employer coverage** — Aging out of employer plan, retirement, spouse losing coverage. 63-day window before/after loss date.

**Dual-eligible status change** — Gaining or losing Medicaid eligibility. Monthly enrollment opportunity with no waiting period.

**5-Star plan SEP** — Clients can switch to a 5-star rated MA or PDP plan once per year, December 8 – November 30. Year-round opportunity.

**Institutional SEP** — Entering or leaving a skilled nursing facility. Monthly enrollment opportunity.

## Moderate-Volume SEP Triggers

**Medicare premium assistance (Extra Help/LIS)** — Qualifying for or losing Low-Income Subsidy. Monthly enrollment.

**Plan contract violation** — If a plan misleads or fails to provide medically necessary services. Variable window.

**Employer group plan changes** — Employer changes, drops, or modifies group coverage mid-year.

**PACE programs** — Entering or leaving Programs of All-Inclusive Care for the Elderly.

## Prospecting Around SEPs

Build referral relationships with: HR departments (employer coverage loss), real estate agents (moves), social workers (dual-eligible changes), hospital discharge planners (institutional SEP), and elder law attorneys (Medicaid eligibility changes).

unLocked CRM tracks SEP-qualifying events for existing clients and triggers outreach automatically when a qualifying change is detected.

## FAQ

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## Related

- https://unlockedcrm.ai/blog/medicare-t65-prospecting-automation
- https://unlockedcrm.ai/blog/best-crm-for-medicare-agents-2026

---

Source: [Medicare Special Enrollment Periods: Every SEP Trigger Agents Must Know](https://unlockedcrm.ai/blog/medicare-special-enrollment-periods-guide) — unLocked CRM, the AI CRM built for insurance agents. Citation permitted with attribution and a link to https://unlockedcrm.ai/blog/medicare-special-enrollment-periods-guide.