If a Medicaid eligible member loses eligibility, what is a valid path to enroll in a plan?

• A. They must wait for the annual enrollment period
• B. They can enroll through a Special Election Period
• C. They can only enroll during AEP
• D. They cannot enroll

Answer: (B)

Special Election Periods are designed for times when a person’s coverage situation changes outside the regular enrollment window. Losing Medicaid eligibility is one of these qualifying events, so it creates an opportunity to enroll in a Medicare plan without waiting for the annual enrollment period. This is why enrolling through an SEP is the valid path here—it aligns with the trigger of the eligibility change and lets you secure coverage promptly. Waiting for the annual enrollment period isn’t necessary when a qualifying event like losing Medicaid eligibility has occurred, and the other options don’t fit because they don’t reflect the enrollment flexibility that SEPs provide.