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I have a few MA customers who are trying to get their Part B back and will have Part B effective on 7-1-17. What is the election situation code that I should use and can they be submitted as early as 4-1-17? Thanks.
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Are General Enrollment Period Part B Plans "ICEPs?"
- Thread starter wehotex
- Start date
- 700
Not sure of the code, but know they have to be submitted prior to 7/1
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I remember for sure I wrote one 2 years ago, Don't know why EP/Sep book states this EP is not available for MA but PDP only,
If I run across one I will still submit it.
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Regarding MAPD and PDP enrollments for 7/1 effective date after GEP enrollment:
There is no SEP-GEP Part B for Medicare Advantage however it's really not an issue because it is always going to be a delay of part B so therefore an ICEP code used
On the flip side there is no such thing as an ICEP code for a PDP .There is a SEP-GEP code for a 7/1 effective PDP enrollment.
As far as time frame for enrollment for both MA and PDP for a 7/1 effective date following a beneficiaries general period enrollment in to part B it it can be done from 4/1- 6/30 for 7/1 effective only
If you read through the CMS MA/MAPD guidelines ("Chapter 2") you'll see there's really no mention about an election related to the GEP since it's based on when Part B starts and that just means you'd have the ICEP available for MA/MAPD enrollment from 4/1 to 6/30 for a 7/1 start.
The PDP SEP-GEP isn't available to everyone just b/c they're starting Part B 7/1. More times than not these people already have Part A (along with Part D eligibility). You have to be paying for your Part A in order to use this SEP.
Straight from the PDP enrollment guidance ("Chapter 3"):
6. SEP for Individuals Who Enroll in Part B during the Part B General Enrollment Period (GEP) – An SEP will be provided to individuals who are not entitled to premium free Part A and who enroll in Part B during the General Enrollment Period for Part B (January – March) for an effective date of July 1st. The SEP will begin April 1st and end June 30th, with an effective date of July 1st.
The PDP SEP-GEP isn't available to everyone just b/c they're starting Part B 7/1. More times than not these people already have Part A (along with Part D eligibility). You have to be paying for your Part A in order to use this SEP.
Straight from the PDP enrollment guidance ("Chapter 3"):
6. SEP for Individuals Who Enroll in Part B during the Part B General Enrollment Period (GEP) – An SEP will be provided to individuals who are not entitled to premium free Part A and who enroll in Part B during the General Enrollment Period for Part B (January – March) for an effective date of July 1st. The SEP will begin April 1st and end June 30th, with an effective date of July 1st.
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Wow I missed that, so it looks like MA only enrollment for 7/1 for consumers who want PDP. Good for agents to know so they don't get consumers locked out of drug coverage by selling med supps for a 7/1
