NOT SCARY AT ALL
What are the dates to use MA-OEP?
Jan.1 to March 31st
Nancy lost her Medicaid last month (received a letter) what enrollment code can I use for Nancy?
SEP-MCD
Florence has had Medicare for 2 years (due to disability) and is unhappy with her plan. She has turned 65 two months ago is she able to switch to a MAPD?
Yes, since she has IEP-65 available
John turned 65 this month, how many months (including this month) left does he have to sign up for a plan within his IEP?
4 months
Jane just moved 1 year ago, but did not give notice to their plan or CMS. Can they still use SEP-MOV?
Yes
(SEP begins when the member notifies the plan and continues for two additional months after the month of notification to the plan.)
Chris has just received a letter stating that his CSNP is terminating as of July 31st (due to his hyper-tension not being observed as a chronic condition) can you help him?
Yes, CHR
Missy has just gotten a letter that she will be going from LIS 1 to LIS 3 what SEP can I use for Missy?
NLS (Gain, Loss, or Change in LIS)
What is the trial period SEP?
This SEP is for individuals who dropped a Medicare Supplement (Medigap) plan after enrolling in an MA/MAPD for the first time, and who are still within 12 calendar months of that first MA/MAPD enrollment.
(Tip: They can only disenroll their MA/MAPD to a PDP)
David and was automatically enrolled two months ago by CMS into a PDP plan and would like more robust coverage, does he have an election period to look at MAPD plans?
Yes, DIF (passive enrollment)
Beneficiary from the state of New York tells you they're enrolled in EPIC what SEP can I use?
SPAP (State Pharmaceutical Assistance Program)
Billy stated he missed out on his IEP due to a storm that affected his area in Belgrade, Nebraska a few months ago would he be eligible to use SEP-DST?
No, since Billy resides in an invalid county.
Tracy just enrolled in an MAPD plan using her IEP election period in June (which is her birth month) and calls to ask you to review her options in August does she have an election period and if so which one?
Yes, OEP-NEW
Shopper has Medicare and Medicaid active (continuing) what SEP can we utilize?
SEP-MDE
Can I use OEP-I if a Medicare beneficiary is leaving a nursing home and returning home?
Yes! this is an open and unlimited use enrollment period for Medicare beneficiaries residing in an institution lasting for up to 2 months after leaving the facility.
What is the hierarchy of election periods?
ICEP/IEP, AEP, OEP, SEP, OEPI