US · guidance
CMS Pub. 100-01, ch. 2, § 40.3.7.4
SEP for Termination of Medicaid Coverage
Individuals whose Medicaid eligibility terminated may enroll during this SEP.
A person may be eligible based on this condition if they have:
• Lost Medicaid entirely,
• Missed a Medicare enrollment period, and
• Their Medicaid coverage was terminated on or after January 1, 2023.
The SEP begins when an individual is notified of an upcoming termination of Medicaid
eligibility and ends six months after the Medicaid termination. Medicare benefits start the
month after Medicare enrollment unless the individual elects a start date back to the first
day of the month the individual lost Medicaid and agrees to pay all prior premiums.
Note: Individuals who are still eligible for Medicaid, including a Medicare Savings
Program, and have not received notice of an upcoming Medicaid termination are not
eligible for this SEP.
History
(Rev. 12046, Issued:05-18-23, Effective:01-01-23, Implementation:06-21-23)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
a20c5102c02b698d0b8ef026cb89828c2779e22300cdcf8d7b751884cf4c9c9a
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