SEP
The consumer is turned 65 on July 1st 2023, and is looking for a Medicare Advantage Plan, when can the consumer enroll and what is the election period?
3 months before and 3 months after plus their birth month (7 months total), What is IEP?
Consumer lives in TN and a Natural disaster occurred January 27th, 2023, The FEMA Declaration date ended May 27th, 2023. Is this incident period valid for a SEP and how so?
What is no, the time period is 2 full months after the declaration end date?
I already verified that there is a Special Election Period for the State of Texas due to a disaster. what tool did I use?
What is FEMA disaster website? OR eHub FEMA SEP Spreadsheet
The last 6 months have been tough for a consumer who has battled severe psychotic episodes. They spent 2 months in a Facility where he received round the clock critical therapy and was released 2 weeks ago. They would like to enroll in an MAPD program. What SEP can they use?
What is the OEPI?
Consumer called in on March 1st 2023 and she stated she is currently on dialysis ( ESRD). Customer is receiving extra help (LIS) Can she enroll into a MA/ MAPD?
What is YES
The customer recently received Part B on June 1st after having Part A already for years. The customer enrolled into an MAPD that became effective June 1st using ICEP. The customer calls you in August, not happy with current plan. The consumer does not have LIS or Medicaid. What SEP can you use?
What is OEP- NEW?
Customer's Extra Help ended January 31st. When she picked up her Meds today, she noticed the cost had drastically increased. It was then she learned her LIS was not renewed. If she needs a plan change what SEP is suitable to complete the enrollment?
What is loss of LIS?
I received a notice from my employer that they are reducing my coverage and it will no longer be considered creditable coverage. What SEP can I use to enroll into a MAPD Plan?
What is involuntary loss of Prescription Drug Coverage?
Some people have too much income to qualify for Medicaid. This amount is called excess income. Some of these people may qualify for Medicaid if they spend the excess income on medical bills. This is called?
What is Spend down
I received a letter from my carrier that my plan contract is terminating on May 31,2023, what is the SEP for this enrollment?
What is contract non-renewal
The customer recently retired on July 31st and employer coverage ended on the same day. The customer Part B started on August 1st and would like to enroll into a MAPD Plan today. What is the SEP?
What is Loss of employer coverage?
Oh, I’m sure glad you called me. I just got the letter about that program you asked me all those questions about. I guess I got it, some ABC program I can’t remember what it was called. It said something about extra help or something like that. What is the election period?
What is Gain LIS?
I live in Miami Florida, and I have a Medigap policy. I want to get a MAPD Plan to get the extra benefits like dental, vision, OTC. I have no Medicaid or LIS and I did not move. What SEP can I use?
What is a 5 Star Plan?
I loss Medicaid on April 30th 2023 and I received a letter from my carrier that my DSNP HMO Plan will be terminated as of May 31st, 2023, what SEP can I used to enroll the customer?
What is loss of Medicaid
I am a disabled veteran, with Medicare Part A and B. I dropped my PDP because I was getting my drugs through the VA. Now I'd like to get an MA plan. Do I have a SEP
YES! What is SEP OCC - for individuals who disenroll from Part D to maintain other creditable coverage.
I want to look at a new plan. I have lived in my same home for 45 years in New York. I am also not with Medicaid, extra help or any of that. The only thing I really have to help is EPIC. That is a nice program but I need help to lower my costs at the doctor. I’m tired of paying so much. What is the SEP?
What is State Pharmaceutical Assistance Program (SPAP)
My 65th birthday is July 1st and I would like to enroll into a MAPD Plan, when does my coverage start if I enroll today?
What is June 1st?
You have just discovered your prospect recently got out of jail for a DUI. He's interested in an MA plan his friend recommends. What is his SEP?
What is: He has none.
Beneficiary has Medicare & Medicaid with LIS and enrolled into Humana Dual SNP HMO Plan in April for May 1st start date. The customer callback today and wants to change her plan, can the consumer change plan?
No, The customer would need to wait for her QTR 3 SEP which starts in July (if no other SEPs are available)
The consumer enrolled into a dual PPO plan using Medicaid Maintaining in Quarter 1 and lost Medicaid eligibility due to income during the same quarter, what SEP can the agent use to enroll the consumer today?
What is: Loss of Medicaid
I moved about 2 years ago but I forgot to change my address. I still have my plan from Tennessee but I’m living in Texas. What do I do now?
SEP: Move with today’s date
My 65th birthday is February 29, when will my plan start if I enrolled with my IEP election?
What is February 1st?
The consumer has Medicare and Medicaid and is interested in enrolling into UHC Dual HMO Plan. Which Carrier Portal do I go to validate the consumer Medicaid level?
What is UHC Jarvis?
Customer enrolled in Medicare Part B in the General Medicare Enrollment Period Between January 1 - March 31, what is the coverage start date?
What is: the first of the month following their enrollment into Part B?
I was recently diagnosed with a Chronic Condition. I need a new plan as my current MAPD is no longer satisfying my specific Medical needs. Could there be a plan that works better for me and what is my SEP?
YES: What is a CSNP plan for your specified condition.