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
True or False. Your client has Medicare A & B as well as a pdp with Humana. Today is 02/02. They ARE allowed to use OEP-A because they are in the proper time period.
FALSE
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)
When an individual states they are in assisted living, there are 3 questions you can ask to validate whether we can assist or not
1. Are you able to come and go as you please
2. Is there an assigned nurse/doctor on site 24/7
3. Do you administer your own medications
This enrollment period is for Part D coverage (MAPD or PDP). 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
True/False. DST and SEP-OTH IS allowed to use with Aetna policies
False
This enrollment is used when a beneficiary has 90+ days between their Part A and Part B. They have 3 months before their part b effective date to enroll
ICEP-Delayed Part B
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 election is for Medical-only coverage (MAO), not MAPD or PDP. The total enrollment period is seven (7) months. This is when the client is in their IEP but enrolling into an MAO
ICEP-Medical Only
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.
OEP NEW
This election period is available when a beneficiaries plan involuntarily ended due to end of contract with Medicare (not renewing in 2024)
NON/MYT
The Annual Enrollment Period is open for all plan types: MA, MAPD, and PDP, but excludes..?
MEDICARE SUPPLEMENTS
Beneficiaries with Medicare due to disability (before age 65) will have a second IEP (7-month period) when they turn 65. This election would be used if the client is in their IEP 2 timeframe, but enrolling into an MAO (Medical Only Plan)
MRD
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 (stop receiving Medicaid benefits, those who have a change in medicaid level, gain of medicaid).
(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