IEP/IEP2/ICEP
Beneficiaries with Medicare due to disability (before age 65) will have a second IEP (7-month period) when they turn 65 to change/enroll in an MAPD or PDP.
IEP2
THE CLIENT HAS THE STATE PAYING PART B PREMIUM
MDE
Available to new Medicare Advantage enrollees following IEP/ICEP with their Medicare entitlement.
OEP NEW
When an individual notifies the plan of a past move date, the SEP begins the month the individual notifies the plan and continues for two (2) additional months
SEP MOVE (MOV)
This SEP may NOT be used during the fourth quarter of the year (Oct-Dec)
(MDE) DUAL ELIGIBLE INDIVIDUALS & LIS
This enrollment period is for Part D coverage (MAPD or PDP), not MA-only. The total enrollment period is seven (7) months
IEP
Individuals who belong to a qualified SPAP are eligible for a SEP to make one enrollment request at any time through the end of each calendar year (i.e. once per year).
(PAP) STATE PHARMACEUTICAL ASSISTANCE PROGRAM
Beneficiaries who wait to use their IEP/ICEP until the month of their Medicare effective date or later during that initial seven-month window will reduce or even forfeit this OEP
OEP New
This SEP is for those individuals with severe or disabling chronic conditions
(CHR) CHRONIC CONDITION
A SEP exists for individuals affected by a disaster or other emergency declared by a Federal, state, or local government entity who were unable to, and did not make an election during another valid election period.
(DST) NO LONGER IN USE
If the beneficiary is adding Part B due to losing creditable coverage, this code will allow enrollment three (3) months prior to the Part B effective date.
ICEP
This SEP is available while covered by an EGHP and ends two (2) months after the EGHP ends or when the election is used - whichever comes first
LEC (LOSS OF EMPLOYER COVERAGE)
Beneficiaries already enrolled in a Medicare Advantage plan (MA/MAPD) may make one plan change during the first three (3) months of each year (1/1-3/31) to enroll in another Medicare Advantage plan
MA OEP
Individuals enrolled in a PDP or MAPD may disenroll to enroll or maintain other creditable drug (such as TriCare or VA coverage) by using this SEP to enroll in an MA-only plan
(OCC) OTHER CREDITABLE COVERAGE
WHAT IS THE HIERARCHY OF ENROLLMENT PERIODS?
1. IEP/ICEP
2. (MA) OEP/OEP-New
3. SEP
4. AEP
5. OEP-I
This code is for Medical-only coverage (MA-only), not MAPD or PDP. The total enrollment period is seven (7) months
ICEP
Beneficiaries may choose how they receive their Medicare benefits for the upcoming year. The last election made, determined by the application date, will be the plan that takes effect on January 1.
AEP
The one-time election begins the month of entitlement (effective date) to Part A and Part B and for two additional months.
MA NEW
Once a contract year, a Medicare beneficiary may enroll in a MA/MAPD/PDP that has an overall Plan Rating of five (5) Stars
(5ST) PLAN WITH 5 STAR RATING
The Annual Enrollment Period is open for all plan types: MA, MAPD, and PDP, but excludes..?
MEDICARE SUPPLEMENTS
If the beneficiary is adding Part B during the General Enrollment Period Jan. 1 - Mar. 31
WHAT ELECTION CODE WILL YOU USE?
WHEN WOULD YOU BE ABLE TO USE THIS?
WHEN WILL THE PLAN BECOME EFFECTIVE?
ICEP DELAYED PART B
APRIL 1 TO JUNE 30
JULY 1 EFFECTIVE DATE
This SEP is for those that become eligible for LIS (but who do not receive Medicaid benefits)
(NLS) GAIN, LOSE, OR HAVE A CHANGE IN THEIR LIS STATUS.
This is an open and unlimited use enrollment period for Medicare beneficiaries residing in an institution lasting for up to two (2) months after leaving the facility.
OEP I
Have a change in the level of assistance they receive (e.g., stop receiving Medicaid benefits, but still qualify for LIS, those who have a change in cost-sharing).
(MCD) GAIN, LOSS, OR CHANGE IN MEDICAID STATUS
If a person had Medicare before age 65, was subject to the Part D late enrollment penalty then uses the 2nd IEP at their 65th birthday to enroll in Part D (PDP or MAPD), the penalty will no longer apply as long as they keep Part D or creditable prescription coverage. WHAT ELECTION CODE IS THIS?
IEP2