sep for Medicare rx plan, after part B effective date.

keith365

Super Genius
118
I have a prospect that has differing part A and B effective dates. Part B was effective on 1/1/18. She wants a drug plan, but when effective dates are different, she has to sign up for the drug plan before her part B effective date. So, what can she do now, other than wait until aep? Does anyone have experience with getting a special circumstances sep for the client not knowing this medicare rule? Thanks!
 
Well, the ICEP for an MA/MAPD ended 12/31/17. So the question becomes why did she delay Part B from Part A? Did she recently leave employer coverage? If yes, does she still have that SEP available?
 
Forget about Part B, the clock starting ticking when Part A became effective. Is the prospect loosing employer group coverage?
 
Huh???

I have a prospect that has differing part A and B effective dates. Part B was effective on 1/1/18. She wants a drug plan, but when effective dates are different, she has to sign up for the drug plan before her part B effective date. So, what can she do now, other than wait until aep? Does anyone have experience with getting a special circumstances sep for the client not knowing this medicare rule? Thanks!
Huh?

1. If her Part B date is 1/1 (and that date is more than 4 months from her Part A), then she had creditable coverage. Late enrollees are effective on July 1.
2. Since she had creditable coverage, she gets 60 days to enroll in a Part D plan, without a penalty.
3. Since its March 1 and Feb only had 28 days this year, THIS MUST BE DONE TODAY.
4. She still won't be effective until April 1
5. You are probably going to have to fight for the enrollment, since it only works because of February
6. You need a copy of the certificate of creditable coverage

My 2 cents: explain this to her and let her know its a "maybe". I damn sure wouldn't guarantee you can get this done.
 
Huh???


Huh?

1. If her Part B date is 1/1 (and that date is more than 4 months from her Part A), then she had creditable coverage. Late enrollees are effective on July 1.
2. Since she had creditable coverage, she gets 60 days to enroll in a Part D plan, without a penalty.
3. Since its March 1 and Feb only had 28 days this year, THIS MUST BE DONE TODAY.
4. She still won't be effective until April 1
5. You are probably going to have to fight for the enrollment, since it only works because of February
6. You need a copy of the certificate of creditable coverage

My 2 cents: explain this to her and let her know its a "maybe". I damn sure wouldn't guarantee you can get this done.

Special election periods are measured in months, not days. About the only thing measured in days is the gap in creditable coverage (63 days). So if the client lost coverage 12/31 then they only had until yesterday 2/28 to enroll. Some people overlap Part B with employer coverage (intentionally or not) so maybe if the other coverage ended 1/31 there's still hope.
 
Special election periods are measured in months, not days. About the only thing measured in days is the gap in creditable coverage (63 days). So if the client lost coverage 12/31 then they only had until yesterday 2/28 to enroll. Some people overlap Part B with employer coverage (intentionally or not) so maybe if the other coverage ended 1/31 there's still hope.

I think they had to go to 63 days to cover all the possible combinations of 2 months plus the first of the following month.
 

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