Ritter Insurance Marketing, Craig Ritter

Health Care Reform Bill Changes Annual Enrollment Period and Eliminates Enrollment into Medicare Advantage During Open Enrollment

UPDATE (3/29) I need to check with the final bill language to verify this.  I think this may not have been included in the final version.

UPDATE (3/30) – Language in this blog post has been corrected to reflect the Final Bill (PPACA 2010).

UPDATE (4/20) – See my notes on the 2011 FINAL CMS Call Letter, including enrollment dates.

The relevant sections of the Bill relating to enrollment periods is Section 3204 – Simplification of Annual Beneficiary Election Periods which can be found on page 338.  (I’ve copied and pasted the entire section below.)

Here are the changes:

  • Changes to the Annual Enrollment Period (formerly 11/15 to 12/31 of each year):    The actual language of the Bill was a bit fuzzy (begs the question if anyone read the whole thing, but one would think one person would have caught this error) as to whether this will begin in 2010 (for 2011 plan year) or 2011 (for 2012 plan year).  The 2011 CMS Call Letter clarifies that for 2010 (2011 Plan Year), the AEP will run from 11/15/2010 through 12/31/2010.  Starting in 2011, the AEP will be changed from 10/15/2011 through 12/7/2011.  I blogged about the lack of an AEP in 2010 for 2011 plans here.
  • The Open Enrollment Period will be shortened in 2011 to 45 days.  The term “Open Enrollment” is a bit of misnomer as now the only options during “Open” “Enrollment” will be to “Disenroll” from a Medicare Advantage plan.  Medicare Beneficiaries who disenroll from Medicare Advantage will be allowed to enroll in a Part D plan (Stand alone PDP) during the OEP.  A better name might be “Closed Disenrollment Period”, but that’s just my opinion.

As mentioned, here is the text:

SEC. 3204. SIMPLIFICATION OF ANNUAL BENEFICIARY ELECTION PERIODS.
(a) ANNUAL 45-DAY PERIOD FOR DISENROLLMENT FROM MA PLANS TO ELECT TO RECEIVE BENEFITS UNDER THE ORIGINAL MEDICARE FEE-FOR-SERVICE PROGRAM.—
(1) IN GENERAL.—Section 1851(e)(2)(C) of the Social Security Act (42 U.S.C. 1395w–1(e)(2)(C)) is amended to read as follows:  ‘‘(C) ANNUAL 45-DAY PERIOD FOR DISENROLLMENT FROM MA PLANS TO ELECT TO RECEIVE BENEFITS UNDER THE ORIGINAL MEDICARE FEE-FOR-SERVICE PROGRAM.—Subject to subparagraph (D), at any time during the first 45 days of a year (beginning with 2011), an individual who is enrolled in a Medicare Advantage plan may change the election under subsection (a)(1), but only with respect to coverage under the original medicare fee-for-service program under parts A and B, and may elect qualified prescription drug coverage in accordance with section 1860D–1.’’.
(2) EFFECTIVE DATE.—The amendment made by paragraph (1) shall apply with respect to 2011 and succeeding years.
(b) TIMING OF THE ANNUAL, COORDINATED ELECTION PERIOD UNDER PARTS C AND D.—Section 1851(e)(3)(B) of the Social Security Act (42 U.S.C. 1395w–1(e)(3)(B)) is amended—
(1) in clause (iii), by striking ‘‘and’’ at the end;
(2) in clause (iv)—

(A) by striking ‘‘and succeeding years’’ and inserting ‘‘, 2008, 2009, and 2010’’; and
(B) by striking the period at the end and inserting ‘‘; and’’; and
(3) by adding at the end the following new clause:  ‘‘(v) with respect to 2012 and succeeding years, the period beginning on October 15 and ending on December 7 of the year before such year.’’.

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