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Medicare Advantage EnrollmentHow do I get more
information and enroll?
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| You are a Hurricane Katrina evacuee and reside in certain zip codes as identified by the Federal Emergency Management Agency at the time of the hurricane (August 2005). | |
| You move permanently outside your plan's service area. | |
| You're enrolled in another prescription drug plan or a Medicare Advantage plan whose contract is terminated. | |
| You lose your previous creditable coverage through no action of your own*. | |
| Your enrollment or non-enrollment is caused by an error by a federal employee or contractor hired by the federal government. | |
| You were eligible for both Medicare and Medicaid (a “dual eligible”) but you lost your dual eligibility status. | |
| You want to move from an employer-sponsored prescription drug plan to a Medicare Prescription Drug Plan. | |
| You want to leave your current Medicare Prescription Drug Plan because it was reprimanded by the federal government or the federal government has determined the plan violated a material provision of its Medicare contract in relation to services provided to you. | |
| You’re enrolled in a Cost Plan that isn’t renewing its contract with Medicare. This SEP begins 90 calendar days prior to the end of the contract year (i.e., October 1) and ends on December 31 of the same year. | |
| You want to move from a Program of All-Inclusive Care for the Elderly—PACE—to an MA-PD. | |
| You live in—or are moving in or out of—a skilled nursing facility, nursing facility, intermediate care facility for the mentally retarded, psychiatric hospital or unit, rehabilitation hospital or unit, long-term care hospital or swing-bed hospital. | |
| Your Medicare entitlement determination is made retroactively | |
| You are not eligible for premium free Part A and enroll in Medicare Part B during the January-March 2007 Part B General Enrollment Period. | |
| You have a low-income subsidy. | |
| The federal government may authorize other special election periods. |
Can I change my Medicare
Advantage plan after I enroll?
Once enrolled in an MA or MA-PD Plan you can change your plan
once between January
01 to March 31 of each year. If you want to change plans again you must wait
until the next Annual Election Period (AEP) every year: November 15 - December
31.
What is the Open
Enrollment Period (OEP)?
During the Open Enrollment Period (OEP) January 01 - March 31 an individual has
the opportunity to make an MA election. During an OEP MA organizations are not
required to open their MA plans for enrollment. However, because Original
Medicare is always open during an OEP, an MA organization must accept valid
requests for disenrollment during the OEP. For 2007 and future years, an MA
eligible individual may make
one MA OEP election
during the first 3 months of the year. A change of election made during an OEP
is limited to the same type of plan in which the individual making the election
is already enrolled. For example, an individual who is enrolled in an MA-PD plan
may elect another MA-PD plan or disenroll from the MA-PD by enrolling in
Original Medicare with coverage under a PDP. An individual who is in Original
Medicare and is enrolled in a PDP may elect an MA-PD. However, the individual
may not elect an MA plan that does not provide qualified prescription drug
coverage.
An MA-eligible individual who is institutionalized, as defined by the Centers for Medicare & Medicaid Services (CMS), can make an unlimited number of MA elections during the OEP. Subject to the MA plan being open to enrollees an MA-eligible institutionalized individual may at any time elect an MA plan or change his or her election from an MA plan to original Medicare, to a different MA plan, or from original Medicare to an MA plan.
Some categories of beneficiaries are not bound by the lock-in rules and may enroll or disenroll from an MA plan in other than the ACEP or OEP. An individual may at any time, during a designated Special Election Period (SEP), discontinue the election of an MA plan offered by an MA organization and change his or her election to original Medicare or to a different MA plan. Examples of situations which may entitle an individual to an SEP include the termination or discontinuation of a plan, a change in residency out of the service area, the organization violating a provision of a contract or misrepresenting the plan’s provisions, or the individual meeting other exceptional conditions as CMS may provide. CMS has also designated an SEP for individuals entitled to Medicare A and B and who receive any type of assistance from Title XIX (Medicaid), including full-benefit dual eligible individuals, as well as those eligible only for the Medicare Savings Programs. This SEP lasts from the time the individual becomes dually eligible until such time as they no longer receive Medicaid benefits. Individuals who are eligible for an SEP under the guidance for Part D enrollment and disenrollment may use that SEP to also make an election into or out of an MA-PD plan.
Important Medicare Advantage Dates to Remember
November 15, 2007
Annual Election Period begins. First day you may elect to enroll in a 2008
Medicare Advantage Plan if you were not previously eligible for ICEP. The plan
effective date will be 01 January 2008.
December 31, 2007
Last day you can enroll in a Medicare Advantage Plan for 2008 unless you qualify
for an exception.
January 1, 2008
First day your 2008 Medicare Advantage plan is effective. Open Enrollment Period
begins, allowing you to switch to another "like" plan type as far as Part D drug
coverage. If your current plan includes Part D drug coverage, then your new plan
must also. If you don't already have Medicare Part D coverage then you cannot
switch to a Medicare Advantage plan that includes Part D drug coverage, nor can
you enroll in a stand-alone Part D plan.
March
31, 2008
Open
Enrollment Period ends. Last day you can switch from one "like" Medicare
Advantage Plan to another (MA to MA or MA-PD to MA-PD). If you don't already
have Medicare Part D coverage then you cannot switch to a Medicare Advantage
Plan that includes Part D coverage.

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