PDP Enrollment

[Winter_123]

Suppose a client is not aging in but is leaving a group plan or an individual non-medicare plan and wants to enroll in a pdp plan outside the AEP.

What are the rules there? Does he come into a full open enrollment period just as if he were aging in and can just sign up for pdp plan. Or does he have to have had a drug plan as part of his previous plan or ? Or does he just have to wait until the next AEP.

How does that work. Thanks.

Winter

 

[Russ]

Suppose a client is not aging in but is leaving a group plan or an individual non-medicare plan and wants to enroll in a pdp plan outside the AEP.

What are the rules there? Does he come into a full open enrollment period just as if he were aging in and can just sign up for pdp plan. Or does he have to have had a drug plan as part of his previous plan or ? Or does he just have to wait until the next AEP.

How does that work. Thanks.

Winter

If it's creditable coverage, they have 60 days from the date their dropped policy ends to get a PDP(check SEP on app). Just had this happen within the last month.

 

[Todd King]

After you send in the app under the SEP, they will most likely correspond with the client to get proof that he has just come off that group plan. The key is, as Russ said, credible coverage. He should have no problem.

 

[Russ]

After you send in the app under the SEP, they will most likely correspond with the client to get proof that he has just come off that group plan. The key is, as Russ said, credible coverage. He should have no problem.

Good point...they will usually respond with the client.