What SEP does my client qualify for, and do I need proof? They just moved to another county.
Your client likely qualifies for the "change of permanent residence" SEP, but whether it applies depends on facts not given here — specifically whether the new county is outside their current plan's service area, and whether they notified the plan before or after the move. The excerpts don't address a "proof of move" documentation requirement, so I can't confirm what, if anything, must be submitted to verify the move.
What the rule says
For MA plans:
“The individual is not eligible to remain enrolled in the plan because of a change in his or her place of residence to a location out of the service area or continuation area or other change in circumstances as determined by CMS but not including terminations resulting from a failure to make timely payment of an MA monthly or supplemental beneficiary premium, or from disruptive behavior.”
For Part D plans:
“The individual is no longer eligible for the PDP because of a change in his or her place of residence to a location outside of the PDP region(s) in which the PDP is offered; or”
CMS guidance explains the timing:
“The SEP begins:”
“The date of the change in permanent residence;”
“The month before the change in permanent residence, for an individual who notifies the MA organization or Part D sponsor in advance of the change; or”
And on effective dates:
“An individual using this SEP may choose an effective date of up to three months after the month in which the plan receives the individual's enrollment request; however, the effective date may not be earlier than the date the individual moves to the new service area and the plan receives the enrollment request.”
This relies on the CY 2027 enrollment guidance, which applies to enrollment requests received on or after January 1, 2027 (and optionally to AEP enrollments effective 1/1/2027).
The deciding facts: whether the new county is outside the current plan's service area, and the exact date of the move/notification.
Carrier and FMO rules are often stricter than CMS rules. This tool reports what CMS sources say and is not legal advice. Enrollment guidance shown is the CY 2027 version. Regulation text reflects the CY 2027 marketing rules, which apply to marketing beginning October 1, 2026.
This answer was generated by mapdbot from the sources listed below on September 23, 2026 and checked against them. Regulation text: eCFR as of 09/15/2026. It is for licensed insurance agents, is not legal advice, and does not cover carrier or FMO rules.