IEP: PDP and MAPD start date relative to A&B start date

Aug 5, 2019

  1. J2727
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    J2727 Super Genius

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    During the IEP:

    - For a PDP or MAPD, if you enroll any 3 month before your birth month, coverage starts your birth month.
    If you enroll on your birth month or any 3 months after, coverage starts 1 month after.

    - For Part A & B, if you enroll 3 months before, coverage starts birth month.
    Enroll birth month, coverage starts 1 month after.
    Enroll 1 month after birth month, coverage starts 2 months later.
    Enroll 2 months after birth month, coverage starts 3 months later.
    Enroll 3 months after birth month, coverage starts 3 months later.​

    If you enroll late, your PDP or MAPD start date will be before your A&B start date.
    I'm assuming the start date of a PDP or MAPD gets delayed and starts when Part B starts since you can't have a PDP or MAPD without A&B.

    Correct?
     
    J2727, Aug 5, 2019
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  2. TwoCents
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    TwoCents Guru

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    No, your thinking is incorrect. Really, except for a couple specific special election periods, enrollment into MA/MAPD/PDP is tied to when your Medicare entitlement begins and not birth month (ie Age 65). It just happens that a big chunk of your newly Medicare eligible obtain it when they turn 65. Seriously, read through the CMS guidelines for MA enrollment and tell me how many times they mention age. A plan, such as Aetna, can't process an enrollment into the entitlement is in place and those entitlement dates will determine the election and plan start date.
     
  3. WCMason
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    WCMason Guru

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    Here are a couple of corrections:
    • The delayed effective dates you've noted here apply only to Part B, not to Part A
    • Part B is not required for a PDP, only for an MA/MAPD, so the start date for a PDP can be earlier than the Part B effective date
    • An MA plan can never start before your Part B effective date
    Other than that you've got it.
     
    WCMason, Aug 5, 2019
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