When Can a Beneficiary Enroll

Enrollment Periods and Effective Dates for Medicare Advantage Prescription Drug (MAPD) plans

The Centers for Medicare and Medicaid (CMS) has established limited periods throughout the year for Medicare beneficiaries to switch to or enroll for the first time in Medicare Advantage Prescription Drug (MA-PD) plans such as Care Improvement Plus offers. Individuals who have diabetes, heart failure, or Medicaid/Low Income Subsidy*, may qualify to enroll in a Care Improvement Plus Special Needs Plan ANYTIME of the year by exercising a "Special Election Period."

Annual Election Period (AEP) — November 15 – December 31
The Annual Election Period (AEP) is for individuals on Medicare who:

• have not yet joined a plan or
• are already enrolled in a plan and want to switch plans

Effective Dates for AEP
Individuals who enroll in a Care Improvement Plus Plan during AEP will be given a January 1 effective date.

Annual Disenrollment Period (ADP) — January 1 – February 14
The Medicare Advantage Annual Disenrollment Period (ADP) allows you to switch from a Care Improvement Plus plan to Original Medicare. Should you choose to switch to Original Medicare during this enrollment period from January 1 through February 14, you can also enroll in a separate Medicare prescription drug plan at the same time.

Special Election Period (SEP)
There are a number of circumstances under which beneficiaries are eligible for a Special Election Period (SEP). If you think the beneficiary you're helping may be eligible for a SEP, review the eligibility statements for our plans to see if any apply. Individuals who have diabetes, heart failure, or Medicaid/Low Income Subsidy*, may qualify to enroll in a Care Improvement Plus Special Needs Plan ANYTIME of the year by exercising a "Special Election Period."

Effective Dates for SEP
The effective date of coverage varies depending on which SEP the beneficiary is using. However, in most cases, the beneficiary's effective date of coverage will be the first day of the month after the month enrollment.

For more information about enrollment periods, effective dates, and to see if the beneficiaries you're helping qualify*, call 1-800-711-1656. Or send an email to:
agent@careimprovementplus.com

Below you will find an overview of general enrollment periods. Since effective dates for coverage depend on the time of enrollment, information about when coverage will go into effect is provided here, as well.

Initial Coverage Election Period (ICEP)
The Initial Coverage Election Period (ICEP) is the period during which an individual who is newly eligible for Medicare may make an initial enrollment request to enroll in a Medicare Advantage plan. Normally, this period begins 3 months before the individual's first entitlement to both Medicare Part A and Part B and ends 3 months after the month of eligibility. For most individuals, this means the ICEP begins 3 months before they turn age 65 and ends 3 months after the month in which they turn 65. For individuals who defer their enrollment into Part B (because, for example, they've continued to work), the ICEP is only the 3 months immediately preceding entitlement to Part B.

Initial Enrollment Period (IEP) for MA-PD
Individuals eligible for Medicare prior to age 65 (such as for disability) will have another Initial Enrollment Period (IEP) upon turning age 65; and may use this "second" IEP to enroll in a Care Improvement Plus MA-PD plan. Note: Care Improvement Plus effective date of coverage cannot be prior to the month a beneficiary is entitled to Medicare Part A and enrollment in Part B. To be eligible for a Care Improvement Plus Chronic Condition Special Needs Plan, you must have diabetes and/or heart failure. Individuals with End Stage Renal Disease are generally not eligible to enroll in Care Improvement Plus unless they are members of our organization and have been since their dialysis began. To be eligible for Care Improvement Plus Dual Advantage (Regional PPO), you must be enrolled in state Medicaid and be a dual eligible beneficiary whom the State holds harmless for Part A and Part B cost sharing.

Note: Care Improvement Plus effective date of coverage cannot be prior to the month a beneficiary is entitled to Medicare Part A and enrollment in Part B.

*For more information about enrollment periods, effective dates, and to see if the beneficiaries you're helping qualify*, call 1-800-711-1656. Or send an email to: agent@careimprovementplus.com<

This page was last updated on: 8/10/2010 12:49:34 PM