Eenie, Meenie, that One!
Which Election Period can a consumer use if they originally enrolled into a SNP plan and no longer meet the eligibility requirements?
Loss of SNP Status
Your caller states that they are retiring soon and would like to set up coverage for once they do. Which Election Period does the caller qualify for?
Loss of EGHP Coverage
If a Consumer moves any distance they automatically qualify for the "Change in Residence - SEP"
False
(Consumers must move out of their current plan's service area in order to qualify for this SEP)
I am moving out of state next month, when can I start a new plan?
SEP begins the month before they move and extends for two months after the move (total of 4 months)
What is an sep that applies when a consumer's plan will not be renewing its service for the upcoming year?
Contract Termination
Which Election Period can a consumer use after losing their Employer Group coverage by voluntary or involuntary means?
Loss of EGHP Coverage
Your caller states that their plan was recently termed. Upon further investigation, you discover that the caller was in a C-SNP plan. The plan was termed due to an unverified condition. Which Election Period does the caller qualify for?
Loss of SNP Status
A Consumer can drop their Medicare Advantage plan and return to Original Medicare during MA-OEP.
True
If I loose my chronic condition do I have to disenroll from my chronic plan?
Only if, you remain ineligible for 30 days to 6 months depending on the plan.
What is an sep that allows consumers who qualify for Medicaid or Extra Help to enroll into a standalone Part D plan?
Dual LIS (Maintaining)
Consumers who qualify for Medicaid or Extra Help assistance can use this election period once per month to enroll into a standalone PDP.
Dual/LIS (Maintaining)
Your caller states that they lost their part B, and their MAPD plan was terminated as a result, but they need some kind of drug coverage. Which Election Period, if any, can you use?
Lost MAPD and Part B
If a consumer's plan is termed due to "Moved out of Service Area," but the consumer never moved. They qualify for the "Involuntary Loss of Creditable Coverage" Election Period.
True
According to cms what is the most commonly use ep?
AEP
What is an sep that allows consumers enrolled in an MAPD or PDP to desenroll from Part D in order to obtain or maintain other types of creditable coverage?
Elig for Other Creditable Coverage
Which Election Period allows newly eligible Medicare consumers to enroll into a MA-Only plan?
Initial Coverage Election Period (ICEP)
Your caller states that they are going to be living in a Rehabilitation Hospital for a couple months and they need to set up a PDP plan for it. Which Election Period, if any, can be used to enroll them?
Institutional
The Dual/LIS (Maintaining) Election Period can be used every month, for qualifying Consumers, to enroll into a MAPD or PDP plan.
False
(This election period cannot be used to enroll into a MAPD plan)
If I am incarcerated can I have an MAPD or PDP plan?
No, CMS specifies that incarcerated individuals do not rec Medicare coverage at all.
What is an sep that applies to consumers who enroll in Part B during the Jan-March General Enrollment Period, allowing them to join a MAPD or PDP with the first 2 months of Part B enrollment?
GEP Part B
Which Election period is made available to individuals recently released from incarceration?
Change in Residence
Your caller states that they have had Medicare for a while now, but they want to enroll into an Advantage plan. After some questioning, you discover they turned 65 two months ago. Which Election Period, if any, would you use to enroll your caller?
IEP2
Consumers who are currently in a State Pharmaceutical Assistance Program can use a unique SEP once per year to enroll into a MAPD or a PDP.
True
(SPAP Enrollee SEP)
Can I enroll in a PDP only with no other coverage?
Yes
What is an sep that allows consumers who tried a Med Adv plan for the first time after dropping their Medigap policy to return to a Supp within 12 month trial period, and also enroll in PDP if they choose?
Indiv Drop Medigap-Trial Period