How do I get more
information and enroll?
Enrolling in a Medicare Advantage Plan is easy. Call us at (866) 806-8753 or
click here for a free Medicare Advantage quote and consultation. We can answer
your questions and handle your enrollment entirely over the phone. If you
prefer, we can mail, fax, email or personally deliver an application to you.
What is the Initial
Coverage Election Period?
The Initial Coverage Election Period ICEP (not to be confused with the Initial
Enrollment Period IEP for Medicare Part D) is a one-time event when an
individual first has the opportunity to enroll in a Medicare Advantage (MA)
plan. It occurs for most people when turning age 65 and enrolling in Medicare
Parts A & B for the first time. This period begins three months before an
individual is first eligible for both Medicare Part A and Part B, and ends on
the later of:
the last day
of the month before the individual is eligible for Parts A and B, or;
the last day
of the individual's Part B initial enrollment period.
The initial enrollment period for Part B is the seven month period that begins
3 months before the month an individual meets the eligibility requirements for
Part B, and ends 3 months after the month of eligibility.
The Initial
Coverage Election Period for a Medicare Advantage (MA) enrollment election will
frequently relate to either the individual's 65th birthday or the 25th month of
disability, but it must always relate to the individual's entitlement to both
Medicare Part A and Part B. When an individual enrolls in a Medicare Advantage-
Prescription Drug (MA-PD) plan she/he used both the Initial Coverage Election
Period and the Initial Enrollment Period (IEP) for Part D.
The Initial
Enrollment Period for Medicare Part D Drug Coverage is the same as the Initial
Enrollment Period for Medicare Part B (the seven month period that begins 3
months before the month an individual meets the eligibility requirement for Part
B, and ends 3 months after the month of eligibility.
During the
Initial Enrollment Period for Part D, individuals may make one Part D enrollment
choice, including enrollment in an MA-PD plan. Individuals eligible for Medicare
prior to age 65 (such as disability) will have another Initial Enrollment Period
for Part D based on upon attaining age 65.
The Initial
Election Coverage Period (ICEP) and the Initial Enrollment Period for Part D (IEP
for Part D) occur together as one period when a newly Medicare eligible
individual has enrolled in BOTH Part A and B at first eligibility. Should an
individual delay enrollment in Part B to a later time, the ICEP and IEP become
separate with the ICEP changing to then occur as the 3 months immediately
proceeding entitlement to both parts A & B.
What is the Annual
Election Period (AEP)?
The Annual Election Period for coverage effective in 2008 begins November 15,
2007 and ends December 31st, 2007. During this period, anyone who is enrolled in
Medicare may enroll for the first time in a Medicare Advantage Plan plan; or
change from one Medicare Advantage Plan plan to another; or return to Original
Medicare from a Medicare Advantage Plan plan. If during this period you enroll
in an Medicare Advantage Plan plan that includes Medicare Part D prescription
drug coverage then any prior Medicare Part D Plan coverage is automatically
cancelled and replaced by the new Medicare Advantage Plan plan with prescription
drug coverage -- these plans are known as MA-PD plans (Medicare Advantage-Part D
plans). Enrollments during this period have an effective date of January 01,
2008. The AEP occurs November 15 through December 31 of every year.
What is a Special
Election Period (SEP)?
A Special Election Period means that you are allowed to enroll in Medicare
Advantage after the IEP and/or AEP because you meet certain conditions set forth
by the government. Below are the specific situations which might qualify you for
a SEP.
You may qualify for a
Special Election Period if:
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.
