SEP 1
What is IEP
Initial eligibility for Medicare. Begins three months before A+B effective dates, month of and three months after. If Enrollment is submitted before A+B start date the effective date is the month of A+B dates otherwise plan will start the following month of Enrollment
What is OEP?
Anyone already enrolled in an MA/MAPD can make a one time change to enroll in a different MA/MAPD or drop back to O.G. Medicare and enroll in a PDP
What is NLS?
Individuals who gain, lose or have a change in the level of LIS (do not qualify for Medicaid)
What is MOV SEP
Move SEP
When is the OEP Period?
1/1-3/31 every year
What is LCC?
Individuals losing coverage Medicare deems as creditable. SEP begins the month of losing coverage and continues two months after
What is OEP-I?
An individual who has resided in an institution for up to 2 months and has left the facility Institutions include nursing home, SNF, mental health facility, rehab hospital or long term care hospital
What is AEP?
10/15-12/7 every year. Anyone receiving Medicare can change plans with an effective date of 1/1
What is ICEP
) If enrolling in M.A. only with no prescription coverage. Seven-month window for Enrollment. Three months before, month of and three months after 2) If a person has Medicare Part A and opted out of Medicare Part B when first eligible and then later enrolled in Part B, the ICEP would occur during the three (3) months before the effective date for Part B
When can an agent use the ICEP SEP?
Before the effective date of the delayed Part B?
What is PAP?
Once per year, change for individuals who are eligible for an SPAP. Can also be used if they no longer qualify and lose that status
What is LEC?
Individuals who are leaving group/employer coverage. SEP begins the month of losing coverage and continues two months after
What is DST?
Reside, or resided at the start of the incident period, in an area for which FEMA has declared an emergency or a major disaster and has designated affected counties as being eligible to apply for individual or public level assistance. •Had another valid election period at the time of incident period; and •Did NOT make an election during that other valid election period
What is NON?
Any plan not renewing its contract or leaving the service area for the following year. SEP begins December 8 and lasts until the end of February
What is SNP?
Individuals enrolled in an SNP plan and who no longer qualify for special needs status. SEP begins the month they no longer qualify and extends 2 months after
When does MOV Period Begins?
The enrollment period begins the day they notify the plan or leave the service area
What is IEP-2?
When someone who had Medicare prior to turning 65, turns 65 year's old
What is OTH SEP?
Individuals who are involuntarily disenrolled from an MAPD plan due to loss of Part B (failure to pay part B premium), but who continue to be entitled to Part A have a SEP to enroll in a PDP. SEP begins when the individual is advised of the loss of Part B continues for two (2) additional months
What is MCD?
Individuals who gain, lose, or have a change in their level of Medicaid (still qualify for LIS). Eligibility begins the month of change/loss and extends two months after.
Can you use MDE during the 4th Quarter after AEP is over?
NO. MDE can only be used during the first 3 quarters of the year.
What is an SEP you can only use Once A Year?
5 STAR RATING SEP
You Can only use this SEP Once a Year unless there is a new Deep-Rooted Diagnosis
Chronic SEP
When can the effective date of a MOV SEP enrollment be?
The enrollment period begins the day they notify the plan or leave the service area. EFFECTIVE DATE CANNOT BE BEFORE THE MOVE DATE
What is LAW?
Non-US citizens who become lawfully present. Individuals can request Enrollment into any MA/MAPD/PDP they qualify for. SEP beginsthe month they become present and extends two months after
What is OCC?
Individuals who are leaving Part D coverage to enroll in another creditable coverage plan such as Tricare or V.A. coverage. Use this to disenroll from PDP/MAPD and enroll into MA-Only