Non Renewal or Terminations
Time-frame that begins December 8 and ends on the last day in February of the following year for members of MA plans that will be affected by plan or contract discontinuation and service area reductions.
What is Non-Renewal SEP?
The SEP for Individuals who Gain, Lose or Have a Change in their Dual or LIS-Eligible Status.
What is SEP – U?
Effective date for a beneficiary using the Non-renewal SEP, whose enrollment request was received in January?
What is February 1?
An SEP does not exists for individuals with ESRD?
What is False?
Number of months that the SEP lasts for members of plans who will be affected by a termination of contract by the MA organization or a modification or termination of the contract by mutual consent.
What is 3 months?
This SEP allows an individual to enroll in, or disenroll from, an MA plan once per calendar quarter during the first nine months of the year.
What is -Dual LIS Quarterly SEP
The SEP Anita should used as she lives in a county that was affected by a tornado.
What is FEMA-Declared Weather Related Emergency or Major Disaster?
An individual currently entitled to Medicare due to a disability and who is attaining age 65, has an MA SEP to coordinate with the additional Part C IEP.
What is False? Part D
Program that an individual defaults to when he/she does not elect an MA plan before the termination effective date of his/her current plan.
What is Original Medicare?
SEP that begins the month an individual’s lawful presence starts.
What is SEP for Non-U.S. Citizens who become Lawfully Present?
The effective dates a beneficiary could choose if an MA organization contract terminates for cause on May 31, and SEP begins April 1 through June 30.
What is May 1, June 1, July 1.
Individuals may disenroll from an MA plan at any time in order to enroll in PACE.
What is True?
Can modify SEPs as necessary for any non-renewals or terminations when the circumstances are unique and warrant a modified SEP.
What is CMS?
The number of enrollment requests that an individual who belongs to a SPAP can make in a calendar year.
What is one request?
Juan has had a successful kidney transplant and no longer has ESRD. This makes him no longer eligible for a ___________
What is Special Needs Plan (SNP)
Individuals who disenroll from PACE have an SEP for up to 6 months after the effective date of PACE disenrollment to enroll in an MA plan.
What is False? 2 months
These type of mergers are not considered terminations or non-renewals.
What is Approved plan consolidations?
The SEP that allows Individuals to disenroll from a Medicare Advantage plan by enrolling in a 5-Star cost plan that is open for enrollment.
What is the 5-Star SEP?
Elisa's MA organization's contract terminates for cause on May 30, when does her SEP start?
What is April 1
Dual LIS Quarterly SEP may be used in the 4th quarter of the year (October – December)
What is False?