Glossary
Five-Star Special Enrollment Period
A once-per-year SEP that lets you switch into a CMS-rated 5-star Medicare Advantage or Part D plan available in your area.
Also known as: 5-Star SEP
Quick answer
The Five-Star SEP allows a beneficiary to enroll in a 5-star-rated MA plan (or 5-star Part D plan) at any time between December 8 and November 30 each year — once per year, outside the normal AEP/OEP windows. CMS publishes star ratings annually each October.
Why it matters
If a 5-star plan becomes available in your ZIP, you don't have to wait for AEP — switch immediately. Star ratings reflect quality, member experience, and outcomes.
When you'll encounter it
Anytime a 5-star plan is offered in your service area between Dec 8 and Nov 30.
Impact on Medicare
Use the SEP to enroll directly with the 5-star plan or via Medicare.gov.
Impact on TRICARE For Life
TFL acts as secondary behind whichever MA plan you ultimately join.
Impact on Medicare Advantage
Standard SEP — applies only to 5-star plans.
Military-specific context
Veteran-focused MA plans (Humana Honor, AARP Patriot, Aetna Eagle) sometimes earn 5-star ratings in select counties. Check CMS Star Ratings each October to see if you qualify.
Common misconceptions
- "I can use the Five-Star SEP multiple times a year." — Once per calendar year.
- "I can use it to move to any plan." — Only to a CMS 5-star plan in your service area.
Real-world scenario: A retiree on a 3.5-star MA plan learns a 5-star plan opened in his county in March.
He uses the Five-Star SEP to switch mid-year — no need to wait for AEP. New plan effective the first of the following month.
Special considerations for military retirees
Five-Star SEP is plan-quality-driven: • Check the CMS Star Ratings page each October. • Confirm provider network on the new 5-star plan before switching. • TFL secondary continues unchanged.
Questions to ask before enrolling
- •Is the new plan's network as strong as my current plan?
- •Are my doctors in the 5-star plan?
- •Does the new plan include my preferred supplemental benefits?
What should I do?
- 1Review CMS Star Ratings annually each October.
- 2If a 5-star plan opens in your ZIP, verify network and benefits before using the SEP.
- 3Enroll directly through the plan or 1-800-MEDICARE.
Continue learning
— suggested by the knowledge graph- Medicare Advantage for veterans: when it makes sense and when it doesn'tCarrier-neutral education on Medicare Advantage (Part C) for retired military — including how MA changes the role of TFL.
- Enrolling in Medicare: timing, methods, and the military-specific rulesWhen and how to sign up for Medicare Parts A and B — and the timing that protects your TRICARE For Life activation.
- Avoiding the Medicare late-enrollment penaltyThe Part B late penalty is permanent — and TRICARE does not waive it. Here's how to make sure you never owe it.
- AEP & OEP (Election Periods)AEP (Oct 15 – Dec 7) is when you can join, switch, or drop MA plans. OEP (Jan 1 – Mar 31) lets you change MA plans once.
- Beneficiary CategoryHow DEERS classifies you (active duty, retiree, family member, survivor, etc.) — determines which TRICARE plans and cost shares apply.
- COBRA After 65COBRA is not creditable coverage for Part B — using it past 65 instead of enrolling in Medicare causes lifetime late penalties.
- Coverage DecisionA formal decision by a Medicare Advantage or Part D plan about whether — and how — it will cover a service, item, or prescription.
- Creditable CoverageNon-Medicare coverage that CMS deems at least as good as a standard Medicare Part D plan — TRICARE Pharmacy qualifies, so TFL beneficiaries don't need Part D.
- Creditable Drug CoveragePrescription drug coverage that CMS certifies is at least as good as standard Medicare Part D — including TRICARE Pharmacy and VA Pharmacy.
- When can I enroll in or switch Medicare Advantage plans?Annual Enrollment Period (Oct 15 – Dec 7) for next-year coverage. MA Open Enrollment Period (Jan 1 – Mar 31) for one change. Special Enrollment Periods for qualifying life events.
- Will I lose TRICARE For Life if I join Medicare Advantage?No. As long as you keep Medicare Part B, TFL stays. Inside an MA plan, MA becomes primary and TFL becomes a secondary wraparound for in-network MA cost-shares.
- I'm turning 65. What should I do first?About 3 months before your 65th birthday, sign up for Medicare Parts A and B at SSA.gov. TRICARE For Life activates automatically once both are effective and DEERS is current.
- Can I keep my current doctor if I enroll in Medicare Advantage?Only if they're in the MA plan's network. Always verify with the plan and the doctor's office before enrolling. Network status can change yearly.
- How do I decide between Medicare Advantage and just Original Medicare + TFL?Stay with Original Medicare + TFL if you want maximum provider choice and travel often. Consider MA if you want a Part B giveback, dental/vision/hearing add-ons, and your doctors are in network.
Related glossary terms
Related Official Resources
Continue learning straight from the source. Every link below goes to an official government or DoD resource.
Last reviewed January 2026 against the 2026 Medicare & You and TRICARE For Life handbooks.