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Medicare Solutions - Did You Know

Part 1: Medicare Advantage Enrollment Period Dos and Don'ts

Hopefully, you already knew that the Affordable Care Act that was passed last year resulted in some pretty significant changes to the Medicare Advantage and Part D election periods. We put together the following as just a helpful reminder of what you can and can’t do during each election period. We hope you find it useful.

Annual  Election Period (AEP) 
October 15th - December 7th.

During this time, beneficiaries may make a plan selection for the next year, which will be effective on January 1st. Prior to 2011, the AEP used to run from November 15th - December 31st, but it changed as a result of the Affordable Care Act.

Agents are NOT permitted to solicit or accept an AEP election before October 15th. Soliciting=directing or encouraging beneficiaries to complete an application. You can offer assistance but you can’t solicit!

Plan carriers and their agents may begin marketing and advertising the new plans as of October 1st, including distributing sales kits and paper applications, but agents can NOT accept applications or keep any part of an application until the election period begins (Oct 15th).


Initial Coverage Enrollment Period (ICEP) 

This is the first time a person may enroll in a Medicare Advantage Plan and it typically comes about due to “aging in” (turning 65) or coming off a group plan. Clients in their initial enrollment period due to “aging in” have three months before the month of their birthday, the month of their birthday, and three months after their birthday to enroll in a Medicare Advantage plan. Clients within their initial enrollment period do not need to wait until the AEP to enroll.


Medicare Advantage Disenrollment Period (MADP)
January 1st - February 14th

The MADP replaced the Open Enrollment Period (OEP) in 2011. During the MADP beneficiaries may choose to disenroll from their MA or MA-PD plan and go back to Original Medicare. During this period the client may enroll in a Part D plan and/or Medicare Supplement plan, but may not switch MA plans. The Medicare Advantage Disenrollment Period explained.


Special Election Period (SEP)
December 8th - February 28th (2012 SEP due to plans leaving the area)

SEPs permit entry into the Medicare Advantage plan for a variety of reasons, including if a person is receiving any assistance from Medicaid, moving permanently outside the service area, canceling from a group plan involuntarily or going through Medicare Advantage plan non-renewal.

For clients who qualify for an SEP because their plan is leaving the area effective December 31st, 2011:

  • Enrollment requests received from December 8 through December 31, 2011, will have an effective date of January 1, 2012.
  • Enrollment requests received in January 2012 will have an effective date of February 1, 2012.
  • Enrollment requests received in February 2012 will have an effective date of March 1, 2012.

Lock-in

This is the period of time once the MADP is over, when no further changes are permitted until the next Annual Enrollment Period.

To get certified to sell Medicare Advantage or contracted with one of our carriers, call the SMS Medicare Solutions department at 1-877-645-0147.