Part D Initial Enrollment Period Question

Oct 16, 2015

  1. aheff
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    Met someone who's Part A effective 10/1/12. Part B effective 10/1/15. Under age 65. In early October 2015, she applied for a MAPD, with an effective date of 11/1/15. Decided she wants Med Sup and Part D. She is in the process of cancelling out the MAPD. Here's my question- can we get the Part D for 11/1/15 (or did she use upthe IEP already for her MAPD app). Any thoughts/help much appreciated. Thanks.
     
    aheff, Oct 16, 2015
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  2. Fisher
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    Uhmmm I'm a bit exhausted but she is still in OE under the Part B date, no? Last app in (the PDP) cancels out the MAPD. Also with different A and B eff. dates it would be ICEP not IEP. I think that's right... but if it were me I would call the enrollment dept. of the PDP carrier. I might even call them twice to make sure I get the same answer each time.

    ----------

    Amazing that there were 70 views of your post and no response.
     
    Fisher, Oct 16, 2015
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  3. sshafran
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    I don't think she would have a Part D election period...just an MAPD election period (for Nov).

    Election Period Guide - "Population: Enrolling into Part B after Delaying Enrollment - not applicable for PDP's"

    She's not T65...
    She didn't get Part B during GEP...

    Does she get LIS?
    Did she lose Creditable Coverage?

    May be able to get an SEP...but I don't think getting Part B on 10/1 allows for a PDP election on 11/1.

    I could be way off..... coffee is still kicking in.

    I guess the bigger question is, why did her part B start on 10/1/15? Did she leave an employer plan?
     
    sshafran, Oct 17, 2015
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  4. Fisher
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    In the light of day I am pretty sure that my initial response above is incorrect. Except for the part about calling the PDP carrier's enrollment dept.

    Shafran's response is much more accurate re. PDP enrollment period. I still get confused at times on the IEP/ICEP scenarios.
     
    Fisher, Oct 17, 2015
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  5. G.Gordon
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    Depends on why she is starting part B now. If due to loss or leaving other coverage then she has shot her SEP once drug coverage goes into effect in either a pdp or mapd. She can enroll in a pdp and it will automatically override the mapd enrollment for a 11/1.

    You're welcome.
     
    Last edited: Oct 17, 2015
    G.Gordon, Oct 17, 2015
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  6. WCMason
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    An initial election is not used up until it takes effect. So if this applicant had a valid election for the MAPD then there is likely still a valid election for a PDP.
     
    WCMason, Oct 17, 2015
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  7. yogooglethis
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    This was not an IEP it was an ICEP.ICEP is for MAPD enrollment for a 10/1/15 effective.Unless this person also has a SEP for loss of EGHP she cannot get drug coverage effective until 1/1/16.I wouldn't advise her to drop MAPD because she can then blame you for no drug coverage for 3 months and if she gets stuck paying for expensive drugs because of this mark my word she will blame you..
     
  8. WCMason
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    If you're right--and I was deliberately vague with my "if the MAPD was a valid election" because I believe you are with the incomplete information we have--then the MAPD enrollment was invalid as well, as it was done after 9/30 according to the OP.
     
    WCMason, Oct 17, 2015
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  9. yogooglethis
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    Your right an ICEP wasn't available for a 11/1 effective in this case so a SEP must have been used for the 11/1 effective.The SEP also could be used again for the 11/1 PDP application as long as mapd application is withdrawn.
     
  10. WCMason
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    That's right. It's either an SEP, which will allow the agent to write the PDP to replace the MA for 11/1 start, or it is not an SEP, and the MA application, which may be still working through the enrollment process, will also get denied. In that case it's a good thing we are in AEP and it's a short 10 weeks until this this person can get one or the other in place. The OP did not provide enough information to know how this will go.
     
    WCMason, Oct 17, 2015
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