Election Periods

[dandan]

I have a question on election periods, seems like companies and Medicare is confused on the question.

If a 64 year old has had Medicare part A Effective 01/2007 and recently got Medicare Part B effective 03/2009, is he eligible for an advantage plan under SEP or any other election period.
He has been on his wife's insurance (Cobra) and Cobra runs out May1, 09.

 

[Professor Leads]

ICEP -- Initial Coverage Election Period would apply when Part B becomes effective.

 

[dandan]

Thanks you... it looks like United health care would know that.. when asked they said since he had part A for a couple years the ruling was unclear..they said to call Medicare well of course Medicare didn't know what to say!
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Thanks you... it looks like United health care would know that.. when asked they said since he had part A for a couple years the ruling was unclear..they said to call Medicare well of course Medicare didn't know what to say!

or Thank you!

 

[jdeasy]

ICEP -- Initial Coverage Election Period would apply when Part B becomes effective.

It's not the ICEP if he didn't take B when first eligible. It is an SEP/loss of creditable coverage, {providing the coverage was creditable}. He has 63 days from the end of coverage to join an MA plan or 63 days from the date he was notified of loss of coverage.

 

[moonlightandmargaritas]

It's not the ICEP if he didn't take B when first eligible. It is an SEP/loss of creditable coverage, {providing the coverage was creditable}. He has 63 days from the end of coverage to join an MA plan or 63 days from the date he was notified of loss of coverage.

This is correct, the Special Election Period applies. Excellent, I'm impressed.

 

[Professor Leads]

It's not the ICEP if he didn't take B when first eligible. It is an SEP/loss of creditable coverage, {providing the coverage was creditable}. He has 63 days from the end of coverage to join an MA plan or 63 days from the date he was notified of loss of coverage.

The ICEP does not END until 3 months after the enrollee enrolls in Medicare part B. Although it technically starts when they become entitled to A and B.

Refer to Section 30.2 of CMS' enrollment guidelines.

 

[Winter_123]

The ICEP does not END until 3 months after the enrollee enrolls in Medicare part B. Although it technically starts when they become entitled to A and B.

I thought it was four months. They are enrolled in Part B as of the first of the month of their birthday, and then three months after that.

 

[jdeasy]

The ICEP does not END until 3 months after the enrollee enrolls in Medicare part B. Although it technically starts when they become entitled to A and B.

Refer to Section 30.2 of CMS' enrollment guidelines.

You are incorrect, sir. The ICEP does run for 3 months before, the month of and 3 months after. However, the situation asked about here is not an ICEP.

Try to enroll someone in this situation and use ICEP as the election period. Get back to me when CMS disallows the enrollment and I'll show how to fix it.

 

[Professor Leads]

I thought it was four months. They are enrolled in Part B as of the first of the month of their birthday, and then three months after that.

That is correct.
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You are incorrect, sir. The ICEP does run for 3 months before, the month of and 3 months after. However, the situation asked about here is not an ICEP.

Try to enroll someone in this situation and use ICEP as the election period. Get back to me when CMS disallows the enrollment and I'll show how to fix it.

That is the IEP...Initial Enrollment Period. IEP and ICEP are not the same.

I have enrolled people in this situation using ICEP and it has gone through.

However, I do not disagree that it would also go through as an SEP/creditable coverage.

 

[dandan]

Isn't the Government wonderful????? We are a bunch of insurance professionals and we cannot agree on the stupid election period!

I was in the prospects home doing a telephonic enrollment and enrollment with UHC asked what election period I stated SEP she hesitated and then said I do not see that in my drop down menu. She said to read the election manual and then give her the proper enrollment period!

I went back to the office called agent support and was told it was a gray area and to call Medicare.... LOL you know the rest of that story.