During the CMS “lock-in” period, agents have an opportunity to enroll consumers who are turning age 65 into Medicare Advantage plans. We are providing guidance to ensure that your enrollments are processed timely, and that you get paid quickly.
Enrollment:
The seven-month Initial Coverage Enrollment Period (ICEP) begins three months prior to an individual’s 65th birthday, includes the month of the birthday, as well as the following three months. Example: the ICEP for someone born in April would be the seven-month period of January through July.
CMS prohibits the company from processing any enrollments that are submitted prior to the start of a person’s IEP. This means that agents may ONLY complete enrollments during the seven-month ICEP window. Example: if a person’s ICEP runs from January through July, the agent may not take an enrollment prior to January 1.
If an agent submits an enrollment form outside the timeframe of a Medicare beneficiary’s ICEP or with an incorrect effective date, the enrollment will be denied and the agent will have to have the Medicare beneficiary complete a new enrollment form within the correct timeframe and with a correct effective date.
Please note that a person who is on Medicare due to disability prior to their 65th birthday has a different election period upon turning 65.
Effective Dates
Enrollments that are taken in one of the three months prior to the month of a client’s 65th birthday: the proposed effective date on the enrollment should be the first day of the month in which the client turns 65.
Enrollments that are taken during the client’s month of birth: the proposed effective date should be the first of the following month.
Enrollments that are taken during one of the three months following the client’s birth month: the proposed effective date should be the first of the following month.
One small correction regarding enrolling after one turns 65. If someone waits to apply for Part B until after their birthday, their Medicare Part B effective date is not the first of the month following application. According to Medicare here is the timeline:
Applies month after 65 B-day: effective 2nd month after month of enrollment
Applies 2 months after 65: effective first of 3nd month after month of enrollment
Applies 3 months after 65: effective first of 3rd month after month of enrollment.
What you state in your blog entry is correct only if the person’s Part B is effective the first of the month of their 65th b-day. For most people this will be the case, but there are some who do delay their enrollment for whatever reason.
Keep up the great information!