The Special Election Period (SEP) for those who LOST their Medicare Advantage plan as of 12/31/09 will be ENDING on 1/31/2010. The SEP will allow them to enroll into a Medicare Advantage plan either WITH or WITHOUT Prescription Drugs REGARDLESS of whether or not the currently have a Medicare Prescription Drug Benefit.
Example: A Medicare Beneficiary had a MAPD PFFS/HMO/PPO plan which non-renewed on 1/1/2010. They did nothing during the AEP. On 1/1/2010, they would automatically be enrolled in Original Medicare with NO prescription drug benefit. If you want to writing this individual an MAPD or a PDP, you MUST code the application with the SEP code and NOT with the OEP code. Recall that OEP enrollment codes do not allow the Medicare Beneficiary to ADD or DELETE a Medicare Prescription Drug benefit, however, the SEP WILL ALLOW THIS.
Also, recall that GUARANTEE ISSUE for Medicare Supplement for these individuals lasts for 63 days from the date of loss. Therefore, if this individual would apply by 3/3/2010 for a Medicare Supplement (Plans A, B, C or F), they would be guaranteed issue. (Ironically, they would need to apply for the Part D plan by 1/31/2010, since these “guarantee periods” are not uniform in terms of their timing.)
Craig
Filipina,
Yes – as long as the company is remaining in that county for the new year and retaining that same plan.
Gary
let me just double check on this one. If a medicare eligible was enrolled to Medicare Advantage Plan with XYZ company and want to continue with it. They don’t need to do anything right? they will be automatically be in the same program?