Assessing LEP

Apr 20, 2016

  1. kstein
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    kstein Guru

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    I know the answer but want to double check. Client is on disability A/B since 2011 and had original Medicare only, no Rx coverage. They now turn 65 and buy a MAPD that has Rx coverage.

    They have an LEP of roughly $20/mo correct? The LEP isn't forgiven BC they are now t65 right??
     
    kstein, Apr 20, 2016
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  2. TDFnCali
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    Yes, I believe the LEP gets "reset" at 65, so they will be fine....Im not 100% sure, but pretty sure.
     
    TDFnCali, Apr 20, 2016
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  3. TwoCents
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    The count of uncovered months will reset upon turning 65 (meaning that the LEP is shed as well).

    From the CMS guidance on creditable coverage and the LEP:

    An individual who is entitled to Medicare prior to turning age 65 (e.g., those who were entitled based on disability), will have a new or subsequent Part D IEP when they become entitled to Medicare based on age. If an enrollee attains age 65 while enrolled in a Part D plan and has been paying an LEP, his/her LEP will end on the day before his/her subsequent IEP begins, which is three months prior to the month s/he attains age 65.
     
    TwoCents, Apr 20, 2016
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  4. kstein
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    Cool. Thanks for the clarity.
     
    kstein, Apr 20, 2016
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