MAPD Enrollment Periods

[wehotex]

Have a new case this week for Medicare, the guy turned 65 two years ago and got Part A. He was on an employer plan, so he waited on part B, which became effective 5/1. Naturally, I assumed that he was in his ICEP until the end of this month, but I wanted to verify with the carrier, simply because of my conversation with him. I knew that he would have been bombarded with calls upon turning 65 and could have been enrolled in just about anything, whether he knew it or not.

Well, he was enrolled in a part d right after t65, so that knocks out his ICEP and he is now OEP-N. I was glad that I called, but I was a little perplexed. It wasn't evident to me that he would have been knocked out of ICEP, just because he enrolled in a part D two years ago. Anyway, it pays to check sometimes.

What I find amazing is the need for all of these election codes; I do understand the logic, for some of them, but others seem to bum into each other for no apparent reason.

The best one I've had to date, was a lady that had Part A only, and an MA plan for three years. They didn't catch it, and I told her that if we tried to change anything she could lose it, and wished her well. Have you ever run into anything like that?

You cannot use ICEP because it's already after 5-1-24. OEP New is only if he is already in an MAPD within the 1st 3 months. Since he just left his EGHP, can you use SEP-Loss of Group Coverage?

 

[DonP]

You don't need all of these EPs for a new part B. Part B effective date trumps everything. Both MA and OM.

Using your example of above, you can write him just like you would a T65.

Incorrect on mapd . What I posted is correct . I've done 100's of delayed part B's were they weren't job related loss of coverage or retirement.Since part b has passed if not job related loss they'll have to use retro or dst sep

 

[BALDELMO]

New SEP.....SEP-PBP....for loss of access to Pickleball Ball Paddle

 

[TwoCents]

New SEP.....SEP-PBP....for loss of access to Pickleball Ball Paddle

Hahaha Seriously, though, just to recap -- Let's say Part A started 2/1/2022 (Part D would start as well), but Part B delayed to 5/1/24. ICEP for MA/MAPD enrollment would be 2/1/24 - 4/30/24.

But starting in 2025, let's say Part B starts 5/1/25, then ICEP is extended by 2 months and would be 2/1/24 - 6/30/24.

Happy to quote CMS on any of this if you lads would like.

 

[rmhaire]

Incorrect on mapd . What I posted is correct . I've done 100's of delayed part B's were they weren't job related loss of coverage or retirement.Since part b has passed if not job related loss they'll have to use retro or dst sep

Then you might want to call Aetna and tell them so. I've written several and they've taken every one.

 

[DonP]

Then you might want to call Aetna and tell them so. I've written several and they've taken every one.

Yes just like Humana takes all kinds of wrong sep codes . Doesn't mean it's correct . Example oep and dst in same qtr . Most CO's take it but how can you have a dst sep when you just used your oep for the same qtr . Well over 1500 apps submitted in my short career I've only had 1 sep denied ever . When I first started I thought the lis sep was activated in the qtr the plan becomes effective . It used the day you write it not the effective date

 

[DonP]

Hahaha Seriously, though, just to recap -- Let's say Part A started 2/1/2022 (Part D would start as well), but Part B delayed to 5/1/24. ICEP for MA/MAPD enrollment would be 2/1/24 - 4/30/24.

But starting in 2025, let's say Part B starts 5/1/25, then ICEP is extended by 2 months and would be 2/1/24 - 6/30/24.

Happy to quote CMS on any of this if you lads would like.

Ok that's nice . By the time most people get there part B only the effective date has passed . Here's a sep for You . Indiana total eclipse dst through June 30 . I didn't know this. DST sept extend 2 months past end date . So mapd is basically yr round

 

[straightnochaser]

Yes just like Humana takes all kinds of wrong sep codes . Doesn't mean it's correct . Example oep and dst in same qtr . Most CO's take it but how can you have a dst sep when you just used your oep for the same qtr . Well over 1500 apps submitted in my short career I've only had 1 sep denied ever . When I first started I thought the lis sep was activated in the qtr the plan becomes effective . It used the day you write it not the effective date

SEP's mean nothing nowadays, super frustrating.