SEPs
It is October 17th
AEP
It is March 2nd, the member has a MAPD and wants a PDP instead
PDP/OEP
Just got Medicare part A and B
IEP
A caller discloses they have dementia during the call. What is the appropriate next step?
What is offer to schedule a follow-up appointment when a trusted individual can be present to assist with enrollment?
Consumers who enrolled into a MA plan when they first qualified for Medicare Part B at age 65 can disenroll at any time in the first 12 months of the health plan coverage.
65
Losing their MA-PD plan due to losing Medicare Part B
Lost MAPD and Part B
Lost L.I.S.
Dual/LIS (Change of Status)
A caller is upset after receiving a bill in the mail. How should you respond?
What is acknowledge and apologize, then complete a needs assessment to identify the issue?
CMS (Medicare Auto assigned a consumer a plan)
CMS / State Assignment
In a standard MAPD plan and has Tri-Care or VA insurance.
Elgbl for Other Creditable Cov
Enrolling into a 5 Star Plan rated by CMS
Five Star
A consumer's MA or Part D plan won't be renewing its service for the coming year
Contract Termination
Enrolling or disenrolling from the Program of All-Inclusive Care for the Elderly
PACE Switcher
Newly Eligible to Medicare and doesn't need drug coverage
ICEP
A consumer who recently signed up for a 5 Star PFFS plan has the option to sign up for a PDP of any star rating.
Coordinating PDP 5 Star
Moved to a different Service Area
Change in Res
A consumers who are unable to enroll during another election period because they live in an area that was affected by a weather emergency or other disaster declared by FEMA
Declared Disaster/Emergency