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Reply to Which SEP Would Apply Here     
Old 07-26-2017, 05:08 PM   #1
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Which SEP Would Apply Here Which SEP Would Apply Here
Little fuzzy on this situation but lets see what the masses say:

Client is over 65. Medicare Part A started 6/2011 and Part B was purchased during the GEP and effective 7/1/17.

Client had no other drug/health insurance and is paying the 10% penalty for Part B.

Client wants $0 HMO MAPD, is he eligible for SEP effective 8/1 (or 7/1). If so which one.

He doesn't want Stand Alone PDP. I think he might be outta luck til AEP.
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Old 07-26-2017, 05:22 PM   #2
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Which SEP Would Apply Here Re: Which SEP Would Apply Here
Originally Posted by kstein View Post
Little fuzzy on this situation but lets see what the masses say:

Client is over 65. Medicare Part A started 6/2011 and Part B was purchased during the GEP and effective 7/1/17.

Client had no other drug/health insurance and is paying the 10% penalty for Part B.

Client wants $0 HMO MAPD, is he eligible for SEP effective 8/1 (or 7/1). If so which one.

He doesn't want Stand Alone PDP. I think he might be outta luck til AEP.


Normally you would use ICEP after a GEP but that is no longer good after 7/1/17 so they will have to wait for AEP
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Old 07-26-2017, 05:45 PM   #3
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WCMason on Which SEP Would Apply Here
 
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Which SEP Would Apply Here Re: Which SEP Would Apply Here
Originally Posted by kstein View Post
Little fuzzy on this situation but lets see what the masses say:

Client is over 65. Medicare Part A started 6/2011 and Part B was purchased during the GEP and effective 7/1/17.

Client had no other drug/health insurance and is paying the 10% penalty for Part B.

Client wants $0 HMO MAPD, is he eligible for SEP effective 8/1 (or 7/1). If so which one.

He doesn't want Stand Alone PDP. I think he might be outta luck til AEP.
You're right about the out of luck part. His ICEP ended June 30 to get an MA or PDP plan. The only thing available to him now is Open Enrollment for a med sup, everything else waits till AEP barring any special elections available like LIS.
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Old 07-27-2017, 08:21 AM   #4
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Which SEP Would Apply Here Re: Which SEP Would Apply Here
Originally Posted by WCMason View Post
You're right about the out of luck part. His ICEP ended June 30 to get an MA or PDP plan. The only thing available to him now is Open Enrollment for a med sup, everything else waits till AEP barring any special elections available like LIS.
There isn't an ICEP for a PDP in this situation. There's an SEP for a PDP for those who get Part B during the GEP, but it's only available for anyone who isn't getting free Part A.
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Old 07-27-2017, 08:29 AM   #5
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Which SEP Would Apply Here Re: Which SEP Would Apply Here
I've been waiting to ask this question, because it wasn't of concern to the op. The PDP question I've been curious about is, in this situation did the PDP IEP tie to the Part A date or the Part B date?

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Old 07-27-2017, 08:54 AM   #6
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Which SEP Would Apply Here Re: Which SEP Would Apply Here
Originally Posted by LostDollar View Post
I've been waiting to ask this question, because it wasn't of concern to the op. The PDP question I've been curious about is, in this situation did the PDP IEP tie to the Part A date or the Part B date?
In this situation, it's usually tied to the Part A date. Unless you have something screwy going on, a person can enroll into a PDP when they start Part A so the PDP IEP occurred then.
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Old 07-27-2017, 10:35 AM   #7
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WCMason on Which SEP Would Apply Here
 
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Which SEP Would Apply Here Re: Which SEP Would Apply Here
Originally Posted by TwoCents View Post
There isn't an ICEP for a PDP in this situation. There's an SEP for a PDP for those who get Part B during the GEP, but it's only available for anyone who isn't getting free Part A.
Thanks for catching that. ICEP is an MA thing; I should not have grouped PDP together with it, as they get SEP code when eligible.
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Old 08-03-2017, 01:51 PM   #8
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Which SEP Would Apply Here Re: Which SEP Would Apply Here
Originally Posted by WCMason View Post
Thanks for catching that. ICEP is an MA thing; I should not have grouped PDP together with it, as they get SEP code when eligible.
MA or MAPD. Otherwise yeah he is SOL til Oct for Jan


I guess secondary questions as obvious answers are gone - SNP plans available? Do they live in NY or WI (SPAP)? Qualify for LIS possibly? Move or can justify declaring a new physical address?
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Old 08-10-2017, 12:49 AM   #9
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Which SEP Would Apply Here Re: Which SEP Would Apply Here
Originally Posted by kstein View Post
Little fuzzy on this situation but lets see what the masses say:

Client is over 65. Medicare Part A started 6/2011 and Part B was purchased during the GEP and effective 7/1/17.

Client had no other drug/health insurance and is paying the 10% penalty for Part B.

Client wants $0 HMO MAPD, is he eligible for SEP effective 8/1 (or 7/1). If so which one.

He doesn't want Stand Alone PDP. I think he might be outta luck til AEP.
IEP/IEP2: 7/1 effective. He still has 3-months before and 3-months after; that never changes. No reason to wait until AEP.
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Old 08-10-2017, 04:11 AM   #10
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Chazm on Which SEP Would Apply Here
 
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Which SEP Would Apply Here Re: Which SEP Would Apply Here
Originally Posted by roygbiv View Post
IEP/IEP2: 7/1 effective. He still has 3-months before and 3-months after; that never changes. No reason to wait until AEP.
It will be rejected. Though I don't use it often it should be ICEP effective 7/1 but you don't get the 3 months after.
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